Individual
LETICIA JUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
879 W 190TH ST, GARDENA, CA 90248-4220
(310) 323-6887
Mailing address
879 W 190TH ST, GARDENA, CA 90248-4220
(310) 323-6887
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
225400000X
Rehabilitation Practitioner
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
07/14/2022
Last updated
05/06/2025
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