Healthcare Provider Details

I. General information

NPI: 1295657849
Provider Name (Legal Business Name): ISAMARIS YOUSEF MALDONADO MPSY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 B JOSEFINA LEGRAND ESQUINA PALMER
CANOVANAS PR
00729-9998
US

IV. Provider business mailing address

D12 CALLE MIS AMORES
CAGUAS PR
00725-5821
US

V. Phone/Fax

Practice location:
  • Phone: 787-903-9863
  • Fax:
Mailing address:
  • Phone: 939-390-4516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number9236
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: