Healthcare Provider Details

I. General information

NPI: 1144130766
Provider Name (Legal Business Name): DRA YAMILETTE BERRIOS MOTA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 165 KM 4.7 LOCAL #8 BO QUEBRADA CRUZ
TOA ALTA PR
00953
US

IV. Provider business mailing address

URB LOMAS VERDES 4X50 CALLE PAVONA
BAYAMON PR
00956-2964
US

V. Phone/Fax

Practice location:
  • Phone: 939-250-2538
  • Fax:
Mailing address:
  • Phone: 939-250-2538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: YAMILETTE BERRIOS MOTA
Title or Position: PRESIDENT / OWNER
Credential: PHD
Phone: 939-250-2538