Provider Demographics
NPI:1770201097
Name:GARCIA, PATRICIA ALEXANDRA
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ALEXANDRA
Last Name:GARCIA
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 1:1029 TYLEEN PL
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91768-2210
Mailing Address - Country:US
Mailing Address - Phone:510-363-0160
Mailing Address - Fax:
Practice Address - Street 1:1029 TYLEEN PL
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91768-2210
Practice Address - Country:US
Practice Address - Phone:510-363-0160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA666176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife