Healthcare Provider Details

I. General information

NPI: 1770099780
Provider Name (Legal Business Name): JOSEPH A. GARCIA PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2017
Last Update Date: 04/30/2023
Certification Date: 04/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 MONTICELLO AVE
WILLIAMSBURG VA
23185-2834
US

IV. Provider business mailing address

324 MONTICELLO AVE
WILLIAMSBURG VA
23185-2834
US

V. Phone/Fax

Practice location:
  • Phone: 757-503-7917
  • Fax: 855-823-3243
Mailing address:
  • Phone: 757-503-7917
  • Fax: 855-823-3243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number0810005884
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number0810005884
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number0810005884
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number0810005884
License Number StateVA
# 6
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810005884
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: