Healthcare Provider Details

I. General information

NPI: 1568918035
Provider Name (Legal Business Name): LUIS M SANCHEZ CASO PSY. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2016
Last Update Date: 08/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

356 CALLE ENSENADA STE E FL 2
SAN JUAN PR
00920-3501
US

IV. Provider business mailing address

PO BOX 360275
SAN JUAN PR
00936-0275
US

V. Phone/Fax

Practice location:
  • Phone: 787-783-0123
  • Fax:
Mailing address:
  • Phone: 787-783-0123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1154
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: