Healthcare Provider Details

I. General information

NPI: 1063996015
Provider Name (Legal Business Name): CENTRO DE ASISTENCIA PSICOEDUCATIVA E INVESTIGACION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2018
Last Update Date: 09/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 CALLE GEORGETTI
NARANJITO PR
00719-3023
US

IV. Provider business mailing address

PO BOX 549
NARANJITO PR
00719-0549
US

V. Phone/Fax

Practice location:
  • Phone: 787-368-3004
  • Fax:
Mailing address:
  • Phone: 787-368-3004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. SHEILA A PAGAN NIEVES
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PH.D
Phone: 787-368-3004