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NPI Code Detail

MEDICARE: DR. VERDEJO BEHAVIORAL HEALTH GROUP, P.S.C.

MEDICARE: DR. VERDEJO BEHAVIORAL HEALTH GROUP, P.S.C.
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
1103TB0200XCognitive & Behavioral Psychologist3971PR
2103TC0700XClinical Psychologist3971PR

General Provider Information

NPI Number : 1699185751
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. VERDEJO BEHAVIORAL HEALTH GROUP, P.S.C.
Provider Business Mailing Address
First Line : PO BOX 192465
Second Line :
City : SAN JUAN
State : PR
Zip : 00919-2465
Country : US
Telephone Number : 787-718-4755
Fax Number :
Provider Business Practice Location Address
First Line : 44 CALLE CARAZO
Second Line : OFICINA 1-C
City : GUAYNABO
State : PR
Zip : 00969-5603
Country : US
Telephone Number : 787-710-4530
Fax Number :
Authorized Official
Title or Position : CLINICAL PSYCHOLOGIST
Name : DR. RANIEL M VERDEJO
Credential : PH.D.
Telephone Number : 787-718-4755
Provider Enumeration Date : 04/29/2014
Last Update Date : 12/24/2025

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