Healthcare Provider Details

I. General information

NPI: 1780490714
Provider Name (Legal Business Name): STEPHANE GUZMAN GARCIA PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 08/19/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO COMERCIAL PLAZA 66 - LOCAL # 2 CARRETERA 848, ESQ. FLORENCIO ROMAN, BO. SAN ANTON
CAROLINA PR
00987-6836
US

IV. Provider business mailing address

QG2 CALLE 525
CAROLINA PR
00982-2019
US

V. Phone/Fax

Practice location:
  • Phone: 787-568-1799
  • Fax: 787-293-9231
Mailing address:
  • Phone: 787-568-1799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number8165
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: