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General NPI Number Information
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NPI Number | 1588516470
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Entity Type | Organization
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Legal Business Name | ORIGEN PSYCHOLOGICAL SERVICES L.L.C.
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | URB SAN AUGUSTO F 12 CALLE SANTONI
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City | GUAYANILLA
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State | PR
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Zip | 00656-0000
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Country | US
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Telephone | 787-690-1120
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Fax |
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Provider Business Mailing Address
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Address Line | URB SAN AUGUSTO F 12 CALLE SANTONI
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City | GUAYANILLA
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State | PR
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Zip | 00656-0000
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Country | US
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Telephone | 787-690-1120
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | CATHERINE JULISSA NOLASCO ORTIZ
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Credential | PSY D
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Telephone | 787-690-1120
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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 |
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License Number State |
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