Provider Demographics
NPI:1235998071
Name:GARCIA, IRIANA MICHELLE
Entity Type:Individual
Prefix:
First Name:IRIANA
Middle Name:MICHELLE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 W GARVEY AVE S
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2652
Mailing Address - Country:US
Mailing Address - Phone:310-505-8256
Mailing Address - Fax:
Practice Address - Street 1:1906 W GARVEY AVE S
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2652
Practice Address - Country:US
Practice Address - Phone:213-618-8061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator