Provider Demographics
NPI:1598213050
Name:GARCIA HERNANDEZ, LUIS MANUEL (MA)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:MANUEL
Last Name:GARCIA HERNANDEZ
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3865 HUMMINGBIRD DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89508-6403
Mailing Address - Country:US
Mailing Address - Phone:775-303-2156
Mailing Address - Fax:
Practice Address - Street 1:6490 S MCCARRAN BLVD STE A6
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6119
Practice Address - Country:US
Practice Address - Phone:775-448-9760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-13
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4668106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist