Healthcare Provider Details

I. General information

NPI: 1538299839
Provider Name (Legal Business Name): JOALENNY PEREZ PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1473 AVE WILSON STE 304
SAN JUAN PR
00907-2364
US

IV. Provider business mailing address

370 CALLE 10 APT 71
TRUJILLO ALTO PR
00976-7817
US

V. Phone/Fax

Practice location:
  • Phone: 787-489-0088
  • Fax:
Mailing address:
  • Phone: 787-568-2044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2780
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2780
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-458771
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number2780
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: