Healthcare Provider Details

I. General information

NPI: 1902786841
Provider Name (Legal Business Name): CLAUDIA ALEJANDRA MEDINA LUNA PSICOLOGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 08/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PR-190, CAROLINA, 00983 CONDOMINIO GOLDEN TOWER
CAROLINA PR
00983
US

IV. Provider business mailing address

CONDOMINIO GOLDEN TOWER APT #412
CARLINA PR
00983
US

V. Phone/Fax

Practice location:
  • Phone: 787-981-2171
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number8195
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: