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General NPI Number Information
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NPI Number | 1689078594
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Entity Type | Individual
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Provider Name | JACQUELINE ROSADO
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Gender | Female
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Dates
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Enumeration Date | 10/21/2014
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | COMUNIDAD CRISTINA 3 CALLE LAS GLADIOLAS
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City | JUANA DIAZ
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State | PR
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Zip | 00795-9998
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Country | US
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Telephone | 939-731-3024
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Fax |
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Provider Business Mailing Address
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Address Line | 15009 CALLE UCAR PASEOS DE JACARANDA
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City | SANTA ISABEL
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State | PR
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Zip | 00757-9600
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Country | US
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Telephone | 787-423-7515
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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 | 1757
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License Number State | PR
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