Provider Demographics
NPI:1710743810
Name:GARZA, ANGELA RAE
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:RAE
Last Name:GARZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:RAE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 11TH ST
Mailing Address - Street 2:
Mailing Address - City:MC FARLAND
Mailing Address - State:CA
Mailing Address - Zip Code:93250-1383
Mailing Address - Country:US
Mailing Address - Phone:661-446-4620
Mailing Address - Fax:
Practice Address - Street 1:21600 OXNARD ST STE 200
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-4971
Practice Address - Country:US
Practice Address - Phone:818-573-6822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician