Provider Demographics
NPI:1700928694
Name:GARZA, MONICA RENEE (MS, ATC, LAT)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:RENEE
Last Name:GARZA
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3252 CORTESE CIR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-5516
Mailing Address - Country:US
Mailing Address - Phone:408-952-9477
Mailing Address - Fax:
Practice Address - Street 1:2145 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1141
Practice Address - Country:US
Practice Address - Phone:408-248-6886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT29922255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAT2992OtherLICENSED ATHLETIC TRAINER