Healthcare Provider Details

I. General information

NPI: 1336355676
Provider Name (Legal Business Name): INES CESAREO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 AVE BARBOSA
CATANO PR
00962
US

IV. Provider business mailing address

5015 CAMINO DEL MAR
TOA BAJA PR
00949
US

V. Phone/Fax

Practice location:
  • Phone: 787-547-0357
  • Fax:
Mailing address:
  • Phone: 787-261-0557
  • Fax: 787-261-0557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1496
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number1496
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: