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General NPI Number Information
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NPI Number | 1093053266
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Entity Type | Individual
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Provider Name | JACQUELINE CASTANEDA PSY.D
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Gender | Female
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Dates
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Enumeration Date | 01/23/2013
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Last Update Date | 05/20/2016
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Provider Practice Location Address
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Address Line | 139 -10 CALLE 401 VILLA CAROLINA 4TA EXTENSION
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City | CAROLINA
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State | PR
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Zip | 00985-4014
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Country | US
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Telephone | 787-397-3223
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Fax |
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Provider Business Mailing Address
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Address Line | L'ANTIGUA LB-18 VIA MALLORCA ENCANTADA
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976-6101
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Country | US
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Telephone | 787-397-3223
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4606
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License Number State | PR
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