Healthcare Provider Details

I. General information

NPI: 1093075111
Provider Name (Legal Business Name): DAIANNA MARLETTE ADAMS ZAMBRANA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2012
Last Update Date: 07/06/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. INDUSTRIAL REPARADA 2 396 DR. LUIS F. SALA
PONCE PR
00716
US

IV. Provider business mailing address

409 PASEO DEL PRINCIPE
PONCE PR
00716-2854
US

V. Phone/Fax

Practice location:
  • Phone: 787-812-2525
  • Fax:
Mailing address:
  • Phone: 939-630-0645
  • Fax: 787-844-2509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4062
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: