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General NPI Number Information
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NPI Number | 1326573890
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Entity Type | Individual
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Provider Name | ELISA GUADALUPE GARCIA FNP
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Gender | Female
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Dates
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Enumeration Date | 04/21/2017
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Last Update Date | 10/06/2024
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Provider Practice Location Address
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Address Line | 3720 HIGHWAY 45
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City | COLUSA
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State | CA
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Zip | 95932-4027
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Country | US
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Telephone | 530-458-0295
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Fax | 530-458-0390
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Provider Business Mailing Address
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Address Line | PO BOX 884
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City | WILLIAMS
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State | CA
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Zip | 95987-0884
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Country | US
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Telephone | 254-245-4637
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95021815
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 95104579
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 553361
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License Number State | CA
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