Active NPI
Ediza Garcia
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1447376181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 22508
- Practice address
- 3250 Wilshire Blvd
Los Angeles, CA 90010-1577 - Phone
- (323) 669-2350
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY 22508 | CA | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PSY 22508 | CA | |
| Psychiatry Physician | 2084P0800X | PSY 22508 | CA | |
| Clinical Psychologist | 103TC0700X | PSY 22508 | CA | Primary |
Addresses
Primary practice location
3250 Wilshire Blvd
Los Angeles, CA 90010-1577
Mailing address
5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY225080 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 22508 | CA | MD | Psychiatry Physician |
| 22508 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Laredo Psychological and Counseling Services | Clinical | Current | Accepting new patients |
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.
-
- Clinical Psychologist
- Laredo, TX
- NPI 1790630010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373587200000",
"number": "1447376181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD",
"address_2": "SUITE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3250 WILSHIRE BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900101577",
"telephone_number": "323-669-2350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "EDIZA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2013-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 22508",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "PSY 22508",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "PSY 22508",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 22508",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY225080",
"state": "CA"
}
],
"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 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.