MEDICARE: MRS. LIANA GARRETT RNP

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	163W00000X	Registered Nurse	RN 362492	CA
2	163WG0000X	General Practice Registered Nurse	RN 362492	CA
3	363LF0000X	Family Nurse Practitioner	0124669	CA
4	363L00000X	Nurse Practitioner	4574	CA

General Provider Information

NPI Number	:	1801984679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LIANA GARRETT RNP

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD STE 400
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 UCLA MEDICAL PLZ STE 365A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-0001
Country	:	US
Telephone Number	:	310-206-8272
Fax Number	:	310-794-2113

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	02/03/2026

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