Healthcare Provider Details

I. General information

NPI: 1821907692
Provider Name (Legal Business Name): DIANELLYS PABON VIERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 CALLE CONSUELO MATOS
SAN JUAN PR
00924-2560
US

IV. Provider business mailing address

URB EL COMANDANTE 1223 CONSUELO MATOS
SAN JUAN PR
00924-2560
US

V. Phone/Fax

Practice location:
  • Phone: 939-321-4397
  • Fax:
Mailing address:
  • Phone: 787-235-5764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number9126
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number9126
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: