Healthcare Provider Details

I. General information

NPI: 1679202063
Provider Name (Legal Business Name): YOLANDA SAEZ-PAGAN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 11/15/2022
Certification Date: 11/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TELEHEALTH SERVICES PROVIDED FROM COTO LAUREL
PONCE PR
00780
US

IV. Provider business mailing address

PO BOX 800311
COTO LAUREL PR
00780-0311
US

V. Phone/Fax

Practice location:
  • Phone: 787-298-3291
  • Fax:
Mailing address:
  • Phone: 787-675-9435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6312
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: