Provider Demographics
NPI:1922729474
Name:GARCIA AVILES, ARMANDO (PHD)
Entity Type:Individual
Prefix:
First Name:ARMANDO
Middle Name:
Last Name:GARCIA AVILES
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 1:106 W OSBORN RD # 1092
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3909
Mailing Address - Country:US
Mailing Address - Phone:480-463-4040
Mailing Address - Fax:
Practice Address - Street 1:3800 N 6TH AVE APT 215
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3731
Practice Address - Country:US
Practice Address - Phone:787-910-7347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR006781103TC0700X
AZPSY-005508103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical