Provider Demographics
NPI:1902073646
Name:GARZA, CARI EILEEN (RN)
Entity Type:Individual
Prefix:MS
First Name:CARI
Middle Name:EILEEN
Last Name:GARZA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:CARI
Other - Middle Name:EILEEN
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:20813 BENZ RD
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:CA
Mailing Address - Zip Code:91350-1422
Mailing Address - Country:US
Mailing Address - Phone:661-904-9098
Mailing Address - Fax:661-309-1419
Practice Address - Street 1:750 E AVENUE Q
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-3882
Practice Address - Country:US
Practice Address - Phone:213-305-3270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA532649163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA01869305OtherMEDI-CAL PROVIDER #