=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003775867
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALLAN JOEL GERENA MENDOZA PSYCHOLOGIST
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/19/2026
-----------------------------------------------------
Last Update Date | 01/19/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 84 CALLE LAGO GUAJATACA
-----------------------------------------------------
City | GURABO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00778-9110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 939-439-7899
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 84 CALLE LAGO GUAJATACA
-----------------------------------------------------
City | GURABO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00778-9110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 939-439-7899
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 8727
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------