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General NPI Number Information
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NPI Number | 1568788057
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Entity Type | Individual
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Provider Name | CARMEN A SANJURJO M.A.
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Gender | Female
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Dates
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Enumeration Date | 04/09/2010
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Last Update Date | 04/09/2010
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Provider Practice Location Address
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Address Line | AVE. IGNACIO ARZUAGA 5 E CAROLINA PROFESSIONAL BUILDING 4TH FLOOR
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City | CAROLINA
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State | PR
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Zip | 00985
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Country | US
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Telephone | 787-768-7900
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Fax |
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Provider Business Mailing Address
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Address Line | HACIENDA REAL JASMIN DEL MAR #300
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City | CAROLINA
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State | PR
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Zip | 00987
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Country | US
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Telephone | 787-550-6587
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 409
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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