Provider Demographics
NPI:1881725604
Name:GARCIA, JOE ALBERT (PHD)
Entity type:Individual
Prefix:DR
First Name:JOE
Middle Name:ALBERT
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 1:1518 FRANKLIN ST APT 6
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-3242
Mailing Address - Country:US
Mailing Address - Phone:310-453-4976
Mailing Address - Fax:
Practice Address - Street 1:111 N LA BREA AVE
Practice Address - Street 2:SUITE 500, ROOM 38
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1752
Practice Address - Country:US
Practice Address - Phone:321-084-6211
Practice Address - Fax:310-677-7205
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB 30216103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical