Healthcare Provider Details

I. General information

NPI: 1750997862
Provider Name (Legal Business Name): ESCUCHA CLINICA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2020
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 CALLE MAYAGUEZ
SAN JUAN PR
00917-5116
US

IV. Provider business mailing address

400 CALLE CALAF STE 21
SAN JUAN PR
00918-1313
US

V. Phone/Fax

Practice location:
  • Phone: 787-405-5818
  • Fax:
Mailing address:
  • Phone: 787-405-5818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ZINNIA SANTIAGO
Title or Position: PRESIDENT
Credential:
Phone: 787-427-4898