Healthcare Provider Details

I. General information

NPI: 1407789241
Provider Name (Legal Business Name): YSAMARA LLUBERES MARTINEZ PSY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 AVE CAMPO RICO
SAN JUAN PR
00924
US

IV. Provider business mailing address

1239 CALLE LUIS CABALLER
SAN JUAN PR
00924-3547
US

V. Phone/Fax

Practice location:
  • Phone: 939-639-3758
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6808
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: