Basic Information
Provider Information
NPI: 1407402779
EntityType: 2
ReplacementNPI:  
OrganizationName: CARMEN N GARABET PSYD A PSYCHOLOGICAL CORPORATION
LastName:  
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Mailing Information
Address1: 415 W ROUTE 66 STE 202
Address2:  
City: GLENDORA
State: CA
PostalCode: 917404335
CountryCode: US
TelephoneNumber: 6269634467
FaxNumber: 6269639543
Practice Location
Address1: 415 W ROUTE 66 STE 202
Address2:  
City: GLENDORA
State: CA
PostalCode: 917404335
CountryCode: US
TelephoneNumber: 6269634467
FaxNumber: 6269639543
Other Information
ProviderEnumerationDate: 08/13/2019
LastUpdateDate: 08/13/2019
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: GARABET
AuthorizedOfficialFirstName: CARMEN
AuthorizedOfficialMiddleName: N
AuthorizedOfficialTitleorPosition: PSYD
AuthorizedOfficialTelephone: 6269634467
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X  Y193400000X SINGLE SPECIALTY GROUPBehavioral Health & Social Service ProvidersPsychologist 

No ID Information.


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