Doctor Name: | TEDAYSHIA GARCIA |
NPI Number: | 1659730778 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 95003355 |
Business Practice Address: | 4004 Beyer Blvd San Ysidro, CA - 921732007 |
Business Phone Number: | 6196624100 |
Business Fax Number: | |
Mailing Address: | 637 Nantucket Dr, CHULA VISTA |
State: | CA |
Postal Code: | 919116820 |
Phone Number: | 6199954848 |
Fax Number: | |
NPI Enumeration Date: | 02/17/2016 |
NPI Last Update Date: | 02/17/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 95003355 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |