Provider Demographics
NPI:1194373118
Name:GARCIA, PAOLA LIZETT (FNP)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:LIZETT
Last Name:GARCIA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 SUNNYSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-4943
Mailing Address - Country:US
Mailing Address - Phone:193-393-7126
Mailing Address - Fax:
Practice Address - Street 1:1600 PACIFIC HWY STE 166
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-2422
Practice Address - Country:US
Practice Address - Phone:619-531-5413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2024-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95203161163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse