Individual provider Active NPI

Juan Garcia, PH.D.

  • Psychologist
  • Las Vegas, NV
National Provider Identifier
1811228760
Registry record updated Apr 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0575 Issued in NV
Practice address
3595 S Town Center Dr
Suite 116
Las Vegas, NV 89135-3019
Phone
(702) 291-8364
Fax
(702) 446-6787
NPI assigned
Jan 15, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0575 NV Primary

Addresses

Primary practice location

3595 S Town Center Dr
Suite 116
Las Vegas, NV 89135-3019

Mailing address

10043 Sand Key St
Las Vegas, NV 89178-4858
Phone (702) 291-8364

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)
Not enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271894400000",
    "number": "1811228760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10043 SAND KEY ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891784858",
            "telephone_number": "702-291-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3595 S TOWN CENTER DR",
            "address_2": "SUITE 116",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891353019",
            "telephone_number": "702-291-8364",
            "fax_number": "702-446-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "JUAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-15",
        "last_updated": "2010-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NV",
            "license": "0575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2010; 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.