Provider Demographics
NPI:1881434652
Name:GARCES, ANGELA VIRGINICA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:VIRGINICA
Last Name:GARCES
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 1:2647 KAREN CT APT 525
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-1249
Mailing Address - Country:US
Mailing Address - Phone:808-218-5175
Mailing Address - Fax:
Practice Address - Street 1:2647 KAREN CT APT 525
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-1249
Practice Address - Country:US
Practice Address - Phone:808-218-5175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician