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General NPI Number Information
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NPI Number | 1528541554
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Entity Type | Individual
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Provider Name | MARLENE GARZA PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/14/2018
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Last Update Date | 07/21/2020
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Provider Practice Location Address
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Address Line | 7381 LA TIJERA BLVD UNIT 45312
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City | LOS ANGELES
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State | CA
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Zip | 90045-7017
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Country | US
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Telephone | 310-948-3182
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Fax |
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Provider Business Mailing Address
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Address Line | 7381 LA TIJERA BLVD UNIT 45312
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City | LOS ANGELES
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State | CA
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Zip | 90045-7017
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Country | US
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Telephone | 310-948-3182
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 31888
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 31888
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License Number State | CA
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