Provider Demographics
NPI:1821666421
Name:GARCIA, MARIELA MARGARITA (SLP)
Entity Type:Individual
Prefix:
First Name:MARIELA
Middle Name:MARGARITA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3721 COGSWELL RD APT A
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-2867
Mailing Address - Country:US
Mailing Address - Phone:626-233-7356
Mailing Address - Fax:
Practice Address - Street 1:2009 W WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4010
Practice Address - Country:US
Practice Address - Phone:323-767-4849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24426235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist