Provider Demographics
NPI:1538553813
Name:GARCIA, KARENA
Entity type:Individual
Prefix:
First Name:KARENA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARENA
Other - Middle Name:
Other - Last Name:ARAUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14360 ST ANDREWS DR
Mailing Address - Street 2:SUITE 11
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-4358
Mailing Address - Country:US
Mailing Address - Phone:760-243-5417
Mailing Address - Fax:
Practice Address - Street 1:12421 HESPERIA RD STE 2
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-7704
Practice Address - Country:US
Practice Address - Phone:760-243-5417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program