Individual provider Active NPI

Maribel Garcia, PYSD

  • Clinical Psychologist
  • Long Beach, CA
National Provider Identifier
1013018050
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY27455 Issued in CA
Practice address
115 Pine Ave Ste 440
Long Beach, CA 90802
Phone
(562) 432-0089
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY27455 CA Primary

Addresses

Primary practice location

115 Pine Ave Ste 440
Long Beach, CA 90802

Mailing address

115 Pine Ave Ste 440
Long Beach, CA 90802-4465
Phone (562) 432-0088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170203002490 CA Practitioner - Clinical Psychologist 9638452303 Practice locations: Long Beach, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY27455CAMDClinical Psychologist
27455CAMDGeneral Care Registered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Maribel Garcia, PSYD Clinical CurrentSince Nov 19, 2021 Accepting new patients

Locations

115 Pine Ave
Ste 440
Long Beach, CA 90802
Phone (562) 248-9409

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1013018050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 PINE AVE STE 440",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024465",
            "telephone_number": "562-432-0088",
            "fax_number": "562-432-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PINE AVE STE 440",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90802",
            "telephone_number": "562-432-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "MARIBEL",
        "name_prefix": "Dr.",
        "credential": "PYSD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.