Healthcare Provider Details

I. General information

NPI: 1518821404
Provider Name (Legal Business Name): STEPHANIE SOSA CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

A5 CALLE SANTA CECILIA
CAGUAS PR
00725-3421
US

IV. Provider business mailing address

A5 CALLE SANTA CECILIA
CAGUAS PR
00725-3421
US

V. Phone/Fax

Practice location:
  • Phone: 939-327-0185
  • Fax:
Mailing address:
  • Phone: 939-327-0185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16372
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: