Healthcare Provider Details

I. General information

NPI: 1285588657
Provider Name (Legal Business Name): BIANCA PAOLA FELICIANO PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 03/15/2026
Certification Date: 03/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

438 CALLE ARECA # C-9
CABO ROJO PR
00623-9385
US

IV. Provider business mailing address

F22 CALLE TUSCANY
YAUCO PR
00698-4110
US

V. Phone/Fax

Practice location:
  • Phone: 787-590-8283
  • Fax:
Mailing address:
  • Phone: 939-608-7431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number8712
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: