Provider Demographics
NPI:1285121822
Name:GARCIA, KAREN DABU
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:DABU
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 1:8554 BURNET AVE UNIT 139
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-6729
Mailing Address - Country:US
Mailing Address - Phone:818-465-4821
Mailing Address - Fax:
Practice Address - Street 1:8554 BURNET AVE UNIT 139
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-6729
Practice Address - Country:US
Practice Address - Phone:818-465-4821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPTA48729225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant