Provider Demographics
NPI:1487703575
Name:GARCIA, GERARD PATRICK (PSYD)
Entity type:Individual
Prefix:DR
First Name:GERARD
Middle Name:PATRICK
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6309 WHITEMAN DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-2188
Mailing Address - Country:US
Mailing Address - Phone:505-552-5506
Mailing Address - Fax:505-552-5530
Practice Address - Street 1:6309 WHITEMAN DR NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-2188
Practice Address - Country:US
Practice Address - Phone:505-552-5506
Practice Address - Fax:505-552-5530
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY003814103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist