Provider Demographics
NPI:1013427202
Name:GARCIA, KAREN ELIZABETH (SLPA)
Entity Type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:ELIZABETH
Last Name:GARCIA
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6210 SOUTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-5321
Mailing Address - Country:US
Mailing Address - Phone:323-889-9897
Mailing Address - Fax:
Practice Address - Street 1:13203 HADLEY ST STE 203
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-4540
Practice Address - Country:US
Practice Address - Phone:562-632-1235
Practice Address - Fax:562-632-1235
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45652355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE3327662Medicaid