Provider Demographics
NPI:1285249631
Name:GARZA, BERTHA GUADALUPE (CARE GIVING)
Entity type:Individual
Prefix:
First Name:BERTHA
Middle Name:GUADALUPE
Last Name:GARZA
Suffix:
Gender:F
Credentials:CARE GIVING
Other - Prefix:
Other - First Name:BERTHA
Other - Middle Name:GUADALUPE
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:42982 SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:CA
Mailing Address - Zip Code:93271-9625
Mailing Address - Country:US
Mailing Address - Phone:559-936-3054
Mailing Address - Fax:
Practice Address - Street 1:42982 SIERRA DR
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:CA
Practice Address - Zip Code:93271-9625
Practice Address - Country:US
Practice Address - Phone:559-936-3054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-12
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care