Healthcare Provider Details

I. General information

NPI: 1720211006
Provider Name (Legal Business Name): ERIKA JANICE MOLINA PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 09/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA PUERTA DEL SOL CALLE MIGUEL OTERO 202 SUITE 101
MANATI PR
00674
US

IV. Provider business mailing address

V9 12TH STREET ALTURAS DE FLAMBOYAN
BAYAMON PR
00959
US

V. Phone/Fax

Practice location:
  • Phone: 787-854-0001
  • Fax: 787-854-0030
Mailing address:
  • Phone: 787-638-8267
  • Fax: 787-854-0030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3384
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code103TE1100X
TaxonomyExercise & Sports Psychologist
License Number3384
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: