Healthcare Provider Details

I. General information

NPI: 1770426512
Provider Name (Legal Business Name): MRS. JESSICA ROMERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N23 CALLE 11
YAUCO PR
00698-2738
US

IV. Provider business mailing address

URB ALTURAS DE YAUCO CALLE 11 N23
YAUCO PR
00698
US

V. Phone/Fax

Practice location:
  • Phone: 787-718-0158
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2307
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: