Healthcare Provider Details

I. General information

NPI: 1336002609
Provider Name (Legal Business Name): SONIA YANINA ESTRELLA SALAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 CALLE DON CHEMARY
MOCA PR
00676-4120
US

IV. Provider business mailing address

99 CALLE DON CHEMARY
MOCA PR
00676-4120
US

V. Phone/Fax

Practice location:
  • Phone: 787-380-4284
  • Fax:
Mailing address:
  • Phone: 787-380-4284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number8711
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: