Most Relevant Information
Provider Data
| NPI Number: | 1003658949 |
| Provider Name: | MIRA ZETA GARCIA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/11/2024 |
| Last Updated: | 06/11/2024 |
Provider Practice Location
1508 W. ARTESIA SQUARE
SUITE B
GARDENA
CA
90248
Practice Location Phone/Fax
| Phone: | 8002491266 |
| Fax: |
Provider Mailing Location
1301 E ORANGEWOOD AVE
ANAHEIM
CA
928056807
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |