Healthcare Provider Details

I. General information

NPI: 1326589912
Provider Name (Legal Business Name): ASHLEY ANN LOPEZ VELAZQUEZ PSYD.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1519 AVE PONCE DE LEON # 23
SAN JUAN PR
00909-1732
US

IV. Provider business mailing address

1511 AVE PONCE DE LEON APT 733
SAN JUAN PR
00909-5051
US

V. Phone/Fax

Practice location:
  • Phone: 939-375-5623
  • Fax:
Mailing address:
  • Phone: 787-718-0609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number005818
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: