Provider Demographics
NPI:1477012979
Name:GARCIA HERMOSILLO, ANA KAREN
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:KAREN
Last Name:GARCIA HERMOSILLO
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 1:140 S FLOWER ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3467
Mailing Address - Country:US
Mailing Address - Phone:714-683-5876
Mailing Address - Fax:
Practice Address - Street 1:140 S FLOWER ST STE 100
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3467
Practice Address - Country:US
Practice Address - Phone:714-683-5876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician