Healthcare Provider Details

I. General information

NPI: 1780124032
Provider Name (Legal Business Name): ANAMARIE SOTO SEDA PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2017
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 CALLE DR SANTIAGO VEVE
SAN GERMAN PR
00683-4193
US

IV. Provider business mailing address

1011 CALLE BAYAHONDA URB REMANSO DE CABO ROJO
CABO ROJO PR
00623-3815
US

V. Phone/Fax

Practice location:
  • Phone: 787-673-1777
  • Fax:
Mailing address:
  • Phone: 787-673-1777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5881
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: