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General NPI Number Information
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NPI Number | 1275098410
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Entity Type | Individual
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Provider Name | ELIZABETH PENA PAYERO PSY.D
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Gender | Female
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Dates
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Enumeration Date | 02/01/2019
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Last Update Date | 02/01/2019
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Provider Practice Location Address
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Address Line | 3326 PASEO CARMEN
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City | TOA BAJA
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State | PR
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Zip | 00949-3136
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Country | US
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Telephone | 939-399-3371
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Fax | 939-399-3372
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Provider Business Mailing Address
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Address Line | 9 CALLE CAPRICORNIO
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City | CAROLINA
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State | PR
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Zip | 00979-4008
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Country | US
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Telephone | 787-449-0817
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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 | 6854
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License Number State | PR
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