Provider Demographics
NPI:1508620550
Name:GARCIA, CAROLINA GUADALUPE
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:GUADALUPE
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 1:5450 W SAHARA AVE STE 250A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-0383
Mailing Address - Country:US
Mailing Address - Phone:702-569-9616
Mailing Address - Fax:
Practice Address - Street 1:612 BERRY CIR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-3800
Practice Address - Country:US
Practice Address - Phone:702-748-6122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant