Provider Demographics
NPI:1265070668
Name:GARCIA JUAREZ, LIZETH BERENICE
Entity type:Individual
Prefix:
First Name:LIZETH
Middle Name:BERENICE
Last Name:GARCIA JUAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 SUE WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-1851
Mailing Address - Country:US
Mailing Address - Phone:775-360-9193
Mailing Address - Fax:
Practice Address - Street 1:1698 MEADOW WOOD LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6707
Practice Address - Country:US
Practice Address - Phone:775-637-0030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-16
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician