Healthcare Provider Details

I. General information

NPI: 1942126024
Provider Name (Legal Business Name): KATHIA YARIE LOPEZ SOTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 422 KM. 1.0 BO. CAPA
MOCA PR
00676
US

IV. Provider business mailing address

HC 4 BOX 13806
MOCA PR
00676-9753
US

V. Phone/Fax

Practice location:
  • Phone: 787-599-6532
  • Fax:
Mailing address:
  • Phone: 787-599-6532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number9064
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: