MEDICARE: GEORGINA AZUCENA GARCIA GARCIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1376498675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGINA AZUCENA GARCIA GARCIA

Provider Business Mailing Address
First Line	:	7422 GARVEY AVE UNIT 204
Second Line	:
City	:	ROSEMEAD
State	:	CA
Zip	:	91770-2974
Country	:	US
Telephone Number	:	626-531-6999
Fax Number	:	626-531-6998

Provider Business Practice Location Address
First Line	:	23371 MULHOLLAND DR UNIT 429
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2734
Country	:	US
Telephone Number	:	626-531-6999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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