Provider Demographics
NPI:1134013105
Name:GARCIA, DEANDRA SHONTEY (CNA 01261423)
Entity type:Individual
Prefix:MISS
First Name:DEANDRA
Middle Name:SHONTEY
Last Name:GARCIA
Suffix:
Gender:F
Credentials:CNA 01261423
Other - Prefix:MISS
Other - First Name:DEANDRA
Other - Middle Name:SHONTEY
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DEANDRA GARCIA
Mailing Address - Street 1:2919 S GENESEE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-3102
Mailing Address - Country:US
Mailing Address - Phone:310-916-7489
Mailing Address - Fax:
Practice Address - Street 1:2919 S GENESEE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-3102
Practice Address - Country:US
Practice Address - Phone:310-916-7489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1261423374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide