Provider Demographics
NPI:1336192319
Name:GARCIA, JAMIE CRYSTALEE (PLP, LPA)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:CRYSTALEE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PLP, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 E SONTERRA BLVD STE 119
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4076
Mailing Address - Country:US
Mailing Address - Phone:210-447-6363
Mailing Address - Fax:210-447-6364
Practice Address - Street 1:255 E SONTERRA BLVD STE 119
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4076
Practice Address - Country:US
Practice Address - Phone:210-447-6363
Practice Address - Fax:210-447-6364
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37147103T00000X, 103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist