Healthcare Provider Details

I. General information

NPI: 1659092245
Provider Name (Legal Business Name): JULISSA GARCIA PHD, DR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 S OYSTER BAY RD
PLAINVIEW NY
11803-3310
US

IV. Provider business mailing address

1095 MCDONALD AVE
WANTAGH NY
11793-1716
US

V. Phone/Fax

Practice location:
  • Phone: 516-888-4357
  • Fax:
Mailing address:
  • Phone: 516-560-0554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: