Provider Demographics
NPI:1639519622
Name:GARZA, LAREINA (CPM, LM)
Entity Type:Individual
Prefix:MRS
First Name:LAREINA
Middle Name:
Last Name:GARZA
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2215
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-0042
Mailing Address - Country:US
Mailing Address - Phone:760-963-9762
Mailing Address - Fax:888-515-8123
Practice Address - Street 1:20807 US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-3549
Practice Address - Country:US
Practice Address - Phone:760-963-3762
Practice Address - Fax:888-515-8123
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA507176B00000X
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula