Provider Demographics
NPI:1801549563
Name:GARCIA, TOMAS JR (PSYD)
Entity type:Individual
Prefix:DR
First Name:TOMAS
Middle Name:
Last Name:GARCIA
Suffix:JR
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2716 KINGSWAY DR
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-1801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4433 S SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CA
Practice Address - Zip Code:90058-2101
Practice Address - Country:US
Practice Address - Phone:747-444-0111
Practice Address - Fax:855-580-5765
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94024175103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical