Basic Information
| Provider Information | |||||||||
| NPI: | 1871877324 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARCIA | ||||||||
| FirstName: | LORENA | ||||||||
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| Credential: | SLPA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2035 N BROADWAY | ||||||||
| Address2: | APT. N | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927062628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9495818239 | ||||||||
| FaxNumber: | 9498590849 | ||||||||
| Practice Location | |||||||||
| Address1: | 23361 MADERO | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MISSION VIEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926912715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9495818239 | ||||||||
| FaxNumber: | 9498590849 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2011 | ||||||||
| LastUpdateDate: | 10/03/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2355S0801X | 282 | CA | Y | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant |
No ID Information.