Provider Demographics
NPI:1790322618
Name:GARCIA, JENNIFER ASHLEY (NP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ASHLEY
Last Name:GARCIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21901 ROSCOE BLVD APT 19
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-3956
Mailing Address - Country:US
Mailing Address - Phone:818-321-1658
Mailing Address - Fax:
Practice Address - Street 1:1334 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA PAULA
Practice Address - State:CA
Practice Address - Zip Code:93060-2926
Practice Address - Country:US
Practice Address - Phone:805-933-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95012470363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily