Healthcare Provider Details

I. General information

NPI: 1366085011
Provider Name (Legal Business Name): JANETH CAJIGAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2019
Last Update Date: 10/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. #2 BO. PUEBLO
HATILLO PR
00627
US

IV. Provider business mailing address

HC 4 BOX 17389
CAMUY PR
00627-7611
US

V. Phone/Fax

Practice location:
  • Phone: 939-292-3112
  • Fax:
Mailing address:
  • Phone: 939-292-3112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1749
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: