Provider Demographics
NPI:1144400417
Name:GARCIA FERNANDEZ, CARMEN I (PSY D)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:I
Last Name:GARCIA FERNANDEZ
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR 833 # KM12.4
Mailing Address - Street 2:BARRIO SANTA ROSA III
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3000
Mailing Address - Country:US
Mailing Address - Phone:787-790-6448
Mailing Address - Fax:787-790-6589
Practice Address - Street 1:CARR 833 # KM12.4
Practice Address - Street 2:BARRIO SANTA ROSA III
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-3000
Practice Address - Country:US
Practice Address - Phone:787-790-6448
Practice Address - Fax:787-790-6589
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000511103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical