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General NPI Number Information
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NPI Number | 1326316407
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Entity Type | Individual
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Provider Name | REGINALDO GERARD GARCIA PHD
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Gender | Male
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Dates
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Enumeration Date | 12/05/2011
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Last Update Date | 12/05/2011
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Provider Practice Location Address
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Address Line | 2558 EAST DR
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City | MONTE VISTA
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State | CO
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Zip | 81144-9335
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Country | US
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Telephone | 719-580-3117
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Fax |
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Provider Business Mailing Address
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Address Line | 2558 EAST DR
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City | MONTE VISTA
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State | CO
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Zip | 81144-9335
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Country | US
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Telephone | 719-580-3117
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1644
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1589
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License Number State | AL
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