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NPI 1659145365

NPI 1659145365 : PAMELA CABALLERO MALDONADO : SAN JUAN, PR

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General NPI Number Information
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    NPI Number           |    1659145365
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    Entity Type          |    Individual 
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    Provider Name        |    PAMELA CABALLERO MALDONADO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/13/2023
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    Last Update Date     |    01/28/2025
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Provider Practice Location Address
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    Address Line         |    315 CALLE MANUEL DOMENECH 
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    City                 |    SAN JUAN
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    State                |    PR
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    Zip                  |    00918-3513
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    Country              |    US
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    Telephone            |    787-412-3162
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1892 
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    City                 |    BAYAMON
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    State                |    PR
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    Zip                  |    00960-1892
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    Country              |    US
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    Telephone            |    787-412-3162
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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       |    6743
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    License Number State |    PR
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