Provider Demographics
NPI:1326316407
Name:GARCIA, REGINALDO GERARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:REGINALDO
Middle Name:GERARD
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2558 EAST DR
Mailing Address - Street 2:
Mailing Address - City:MONTE VISTA
Mailing Address - State:CO
Mailing Address - Zip Code:81144-9335
Mailing Address - Country:US
Mailing Address - Phone:719-580-3117
Mailing Address - Fax:
Practice Address - Street 1:2558 EAST DR
Practice Address - Street 2:
Practice Address - City:MONTE VISTA
Practice Address - State:CO
Practice Address - Zip Code:81144-9335
Practice Address - Country:US
Practice Address - Phone:719-580-3117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1644103TC0700X
AL1589103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical