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General NPI Number Information
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NPI Number | 1760704175
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Entity Type | Individual
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Provider Name | VIRGEN C RENTA PHD
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Gender | Female
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Dates
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Enumeration Date | 02/26/2010
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | KM HM 7.3 CARR 153 PLAZA SANTA ISABEL LOCAL 15B BO JAUCA II
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City | SANTA ISABEL
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State | PR
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Zip | 00757
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Country | US
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Telephone | 939-222-7598
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Fax |
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Provider Business Mailing Address
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Address Line | 39 ESTANCIAS DE CIDRA
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City | CIDRA
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State | PR
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Zip | 00739
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Country | US
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Telephone | 787-220-9971
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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 | 3644
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License Number State | PR
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