Healthcare Provider Details

I. General information

NPI: 1467377903
Provider Name (Legal Business Name): WENDY GARCIA LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 BOWMAN TRL
YUCCA VALLEY CA
92284-0819
US

IV. Provider business mailing address

187 BOWMAN TRL
YUCCA VALLEY CA
92284-0819
US

V. Phone/Fax

Practice location:
  • Phone: 323-388-8201
  • Fax:
Mailing address:
  • Phone: 323-388-8201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number103026
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: