Healthcare Provider Details

I. General information

NPI: 1447581582
Provider Name (Legal Business Name): REINALDO OQUENDO PH,D A.B.D , PCTFP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2010
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ST. 833 KM. 12.4 BO. LOS FRAILES
GUAYNABO PR
00970
US

IV. Provider business mailing address

PRADERA DEL RIO # 3112 ST. RIO BUCANA
TOA ALTA PR
00953-9111
US

V. Phone/Fax

Practice location:
  • Phone: 787-790-6448
  • Fax:
Mailing address:
  • Phone: 787-458-0161
  • Fax: 787-799-4148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2275
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2275
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: