=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144130766
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DRA YAMILETTE BERRIOS MOTA LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2026
-----------------------------------------------------
Last Update Date | 09/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CARR 165 KM 4.7 LOCAL #8 BO QUEBRADA CRUZ
-----------------------------------------------------
City | TOA ALTA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00953
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 939-250-2538
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | URB LOMAS VERDES 4X50 CALLE PAVONA
-----------------------------------------------------
City | BAYAMON
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00956-2964
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 939-250-2538
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT / OWNER
-----------------------------------------------------
Name | YAMILETTE BERRIOS MOTA
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 939-250-2538
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------