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General NPI Number Information
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NPI Number | 1194037671
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Entity Type | Individual
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Provider Name | IVETTE BAERGA PSYD
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Gender | Female
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | CALLE MARGINAL 706 FUENTE TOWN CENTER LOCAL 221 224
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City | GUAYAMA
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State | PR
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Zip | 00784-6045
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Country | US
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Telephone | 787-704-0705
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Fax |
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Provider Business Mailing Address
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Address Line | 223 CALLE PERLA URBANIZACION ESTANCIAS
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City | SANTA ISABEL
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State | PR
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Zip | 00757-2092
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Country | US
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Telephone | 787-340-1815
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10399
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 8103
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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