Provider Demographics
NPI:1003035874
Name:GARCIA, RAYMOND (VN190273)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:VN190273
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9813 CASPI GARDENS DR
Mailing Address - Street 2:# 1
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-1805
Mailing Address - Country:US
Mailing Address - Phone:619-322-1577
Mailing Address - Fax:
Practice Address - Street 1:9813 CASPI GARDENS DR
Practice Address - Street 2:# 1
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-1805
Practice Address - Country:US
Practice Address - Phone:619-322-1577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN190273164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse