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General NPI Number Information
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NPI Number | 1679087795
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Entity Type | Individual
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Provider Name | JUANA P CASTILLO MUNOZ PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/28/2017
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 1007 AVE MUNOZ RIVERA STE 1001
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City | SAN JUAN
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State | PR
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Zip | 00925-2724
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Country | US
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Telephone | 787-957-5788
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Fax |
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Provider Business Mailing Address
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Address Line | 1007 AVE MUNOZ RIVERA APT 706
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City | SAN JUAN
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State | PR
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Zip | 00925-2723
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Country | US
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Telephone | 787-425-9885
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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 | 005405
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License Number State | PR
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