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General NPI Number Information
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NPI Number | 1679153993
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Entity Type | Individual
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Provider Name | JESUS SOTO ESPINOSA P.H.D.
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Gender | Male
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Dates
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Enumeration Date | 04/11/2021
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Last Update Date | 05/30/2022
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Provider Practice Location Address
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Address Line | 530 CALLE JUAN DAVILA
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City | SAN JUAN
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State | PR
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Zip | 00918-2750
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Country | US
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Telephone | 787-444-6571
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Fax |
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Provider Business Mailing Address
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Address Line | 530 CALLE JUAN DAVILA
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City | SAN JUAN
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State | PR
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Zip | 00918-2750
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Country | US
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Telephone | 787-444-6571
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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 | 1976
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License Number State | PR
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