MEDICARE: DR. CHRISTIAN GARNICA PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TF0200X	Forensic Psychologist

General Provider Information

NPI Number	:	1275050031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTIAN GARNICA PSYD

Provider Business Mailing Address
First Line	:	PO BOX 19035
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92159-0035
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2535 KETTNER BLVD STE 2B1
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-1253
Country	:	US
Telephone Number	:	619-800-4471
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2017
Last Update Date	:	11/10/2022

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