MEDICARE: DR. RICHELYS TEJERO PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	8299	PR

General Provider Information

NPI Number	:	1487464111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHELYS TEJERO PSYD

Provider Business Mailing Address
First Line	:	3864 VALLE COSTERO CALLE ALGAS
Second Line	:
City	:	SANTA ISABEL
State	:	PR
Zip	:	00757
Country	:	US
Telephone Number	:	939-905-2910
Fax Number	:

Provider Business Practice Location Address
First Line	:	3020 AVE SAN CRISTOBAL
Second Line	:
City	:	COTO LAUREL
State	:	PR
Zip	:	00780-2896
Country	:	US
Telephone Number	:	939-905-2910
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2025
Last Update Date	:	02/11/2025

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