Provider Demographics
NPI:1114549904
Name:GARCIA, JULIAN A (PSYD LCP)
Entity Type:Individual
Prefix:
First Name:JULIAN
Middle Name:A
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PSYD LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 780125
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0125
Mailing Address - Country:US
Mailing Address - Phone:804-922-4844
Mailing Address - Fax:
Practice Address - Street 1:8730 STONY POINT PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1970
Practice Address - Country:US
Practice Address - Phone:804-327-1166
Practice Address - Fax:804-327-1170
Is Sole Proprietor?:No
Enumeration Date:2020-05-14
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810007865103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical