Provider Demographics
NPI:1104371681
Name:GARCIA, MARIALUISA (MSN, FNP)
Entity Type:Individual
Prefix:
First Name:MARIALUISA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-6155
Mailing Address - Country:US
Mailing Address - Phone:909-467-1425
Mailing Address - Fax:909-773-0266
Practice Address - Street 1:1151 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-6155
Practice Address - Country:US
Practice Address - Phone:909-467-1425
Practice Address - Fax:909-773-0266
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95004668363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily