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Individual

EDIZA GARCIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3250 WILSHIRE BLVD, LOS ANGELES, CA 90010-1577
(323) 669-2350
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY 22508
CA
103TC0700X
Clinical Psychologist
Primary
PSY 22508
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY 22508
CA
2084P0800X
Psychiatry Physician
PSY 22508
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PSY225080
CA
Enumeration date
03/22/2007
Last updated
07/12/2013
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