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General NPI Number Information
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NPI Number | 1972139798
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Entity Type | Individual
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Provider Name | CAMILLE ROCIO BAEZ RAMOS PSYD
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Gender | Female
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Dates
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Enumeration Date | 03/13/2020
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Last Update Date | 06/18/2020
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Provider Practice Location Address
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Address Line | 355 CALLE FONT MARTELO
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City | HUMACAO
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State | PR
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Zip | 00791-3249
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Country | US
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Telephone | 787-517-3353
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Fax | 787-561-7464
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Provider Business Mailing Address
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Address Line | HC 5 BOX 5399
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City | YABUCOA
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State | PR
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Zip | 00767-9672
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Country | US
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Telephone | 787-517-3353
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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 | 6323
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License Number State | PR
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