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General NPI Number Information
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NPI Number | 1255872990
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Entity Type | Individual
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Provider Name | LISETTE GARCIA MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 03/14/2017
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 26091 MERIDIAN ST
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City | HEMET
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State | CA
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Zip | 92544-6401
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Country | US
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Telephone | 951-765-1660
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Fax |
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Provider Business Mailing Address
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Address Line | 27125 LAMDIN AVE
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City | MENIFEE
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State | CA
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Zip | 92584-9097
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Country | US
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Telephone | 951-440-7566
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355A2700X
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Taxonomy Name | Audiology Assistant
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License Number | 4298
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 31885
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License Number State | CA
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