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General NPI Number Information
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NPI Number | 1750182374
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Entity Type | Individual
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Provider Name | MRS. VANESSA CORTINAS GARZA
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Gender | Female
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 14200 RUNNYMEDE ST
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City | VAN NUYS
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State | CA
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Zip | 91405-1435
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Country | US
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Telephone | 818-389-1184
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Fax |
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Provider Business Mailing Address
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Address Line | 5255 ZELZAH AVE APT 107
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City | ENCINO
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State | CA
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Zip | 91316-2150
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Country | US
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Telephone | 310-291-1314
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | C42D8EC41C
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License Number State | CA
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