Provider Demographics
NPI:1104140656
Name:GARCIA, MONICA MASSARO (PSYD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:MASSARO
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:MASSARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1221 E ELIZABETH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4066
Mailing Address - Country:US
Mailing Address - Phone:925-337-0415
Mailing Address - Fax:
Practice Address - Street 1:1221 E ELIZABETH ST STE 3
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4066
Practice Address - Country:US
Practice Address - Phone:970-829-8619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0004741103T00000X
CA26441103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist