Healthcare Provider Details

I. General information

NPI: 1659577419
Provider Name (Legal Business Name): YALESKA COLON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BD14 CALLE RIO ORINOCO URB. VALLE VERDE 2
BAYAMON PR
00961-3268
US

IV. Provider business mailing address

BD14 CALLE RIO ORINOCO URB. VALLE VERDE 2
BAYAMON PR
00961-3268
US

V. Phone/Fax

Practice location:
  • Phone: 787-454-6496
  • Fax: 787-993-1790
Mailing address:
  • Phone: 787-454-6496
  • Fax: 787-993-1790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2239
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: