Healthcare Provider Details

I. General information

NPI: 1144512203
Provider Name (Legal Business Name): JENNIFER CUEVAS PSY D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2011
Last Update Date: 04/21/2024
Certification Date: 04/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CALLE ACERINA
CAGUAS PR
00725-2076
US

IV. Provider business mailing address

PO BOX 1053
CAGUAS PR
00726-1053
US

V. Phone/Fax

Practice location:
  • Phone: 939-489-1112
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3862
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: