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NPI Code Detail

MEDICARE: MS. MARIELA JACQUELINE GARCIA BCBA

MEDICARE: MS. MARIELA JACQUELINE GARCIA BCBA
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
1103K00000XBehavior Analyst1-18-32023CA

General Provider Information

NPI Number : 1669957502
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARIELA JACQUELINE GARCIA BCBA
Provider Business Mailing Address
First Line : 21820 BURBANK BLVD STE 310
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-6481
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 123 S MONTEBELLO BLVD
Second Line :
City : MONTEBELLO
State : CA
Zip : 90640-4729
Country : US
Telephone Number : 323-887-7900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2018
Last Update Date : 05/02/2024

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