Provider Demographics
NPI:1265626097
Name:ALICIA A. GARCIA,PH.D.,L.L.C.
Entity type:Organization
Organization Name:ALICIA A. GARCIA,PH.D.,L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:602-418-3113
Mailing Address - Street 1:14188 N 106TH WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-1762
Mailing Address - Country:US
Mailing Address - Phone:602-418-3113
Mailing Address - Fax:602-604-9600
Practice Address - Street 1:1702 E HIGHLAND AVE STE 404
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4630
Practice Address - Country:US
Practice Address - Phone:602-418-3113
Practice Address - Fax:602-604-9600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ03552103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ75377Medicare PIN