Healthcare Provider Details

I. General information

NPI: 1053514240
Provider Name (Legal Business Name): MAUREEN MCGARTY PSYCHOLOGIST PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 SAN MARCOS ROAD
SAN DIMAS CA
91773-3331
US

IV. Provider business mailing address

531 SAN MARCOS ROAD
SAN DIMAS CA
91773-3331
US

V. Phone/Fax

Practice location:
  • Phone: 706-340-6131
  • Fax:
Mailing address:
  • Phone: 706-340-6131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY001230
License Number StateGA

VIII. Authorized Official

Name: DR. MAUREEN ANN MCGARTY
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 706-340-6131