Provider Demographics
NPI:1700696226
Name:GARDE, VERONICA (FNP-C)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:GARDE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13973 BLOSSOM WAY
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-6409
Mailing Address - Country:US
Mailing Address - Phone:520-213-6249
Mailing Address - Fax:
Practice Address - Street 1:NEW AGE GASTROENTEROLOGY
Practice Address - Street 2:2195 CLUB CENTER DR. STE A
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408
Practice Address - Country:US
Practice Address - Phone:909-654-2199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027251207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine