Healthcare Provider Details

I. General information

NPI: 1174091417
Provider Name (Legal Business Name): VALERIA SOFIA MENDEZ PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 CALLE DR BASORA N
MAYAGUEZ PR
00680-4810
US

IV. Provider business mailing address

PO BOX 3381
MAYAGUEZ PR
00681-3381
US

V. Phone/Fax

Practice location:
  • Phone: 787-986-7078
  • Fax:
Mailing address:
  • Phone: 787-614-1473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7979
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: