Healthcare Provider Details

I. General information

NPI: 1235944406
Provider Name (Legal Business Name): JESSICA IRIZARRY BARRETO MA, PSYCHOLOGIST PR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ALTURAS DE RIO GRANDE A20 CALLE 1
RIO GRANDE PR
00745-3303
US

IV. Provider business mailing address

ALTURAS DE RIO GRANDE A20 CALLE 1
RIO GRANDE PR
00745-3306
US

V. Phone/Fax

Practice location:
  • Phone: 939-279-1762
  • Fax:
Mailing address:
  • Phone: 939-279-1762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number8170
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: