Provider Demographics
NPI:1154466399
Name:GARRIDO, ALICIA E (NP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:E
Last Name:GARRIDO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:12157 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3204
Mailing Address - Country:US
Mailing Address - Phone:818-755-8000
Mailing Address - Fax:818-755-8006
Practice Address - Street 1:801 S CHEVY CHASE DR STE 20
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-4437
Practice Address - Country:US
Practice Address - Phone:818-265-2210
Practice Address - Fax:818-291-0291
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA468487363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC71013FMedicaid