Individual provider Active NPI

Raul Anthony Garcia, PH.D.

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1164506499
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 17284 Issued in CA
Practice address
Cesar E Chavez Ave FL 2
Los Angeles, CA 90022
Phone
(323) 267-3400
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PSY 17284 CA Primary

Addresses

Primary practice location

Cesar E Chavez Ave FL 2
Los Angeles, CA 90022

Mailing address

4701 E Cesar E Chavez Ave FL 2
Los Angeles, CA 90022-1209
Phone (323) 267-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 17284CAMDClinical Psychologist
17284CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164506499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 E CESAR E CHAVEZ AVE FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221209",
            "telephone_number": "323-267-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CESAR E CHAVEZ AVE FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90022",
            "telephone_number": "323-267-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "RAUL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 17284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.