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NPI Code Detail

MEDICARE: CLARA FAJARDO PSYCHOLOGY

MEDICARE: CLARA FAJARDO PSYCHOLOGY
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
1103TC0700XClinical Psychologist
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1730034216
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLARA FAJARDO PSYCHOLOGY
Provider Business Mailing Address
First Line : 971 US HIGHWAY 202 N STE N
Second Line :
City : BRANCHBURG
State : NJ
Zip : 08876-3757
Country : US
Telephone Number : 646-389-1664
Fax Number :
Provider Business Practice Location Address
First Line : 79 HUDSON ST STE 105LL
Second Line :
City : HOBOKEN
State : NJ
Zip : 07030-5640
Country : US
Telephone Number : 646-389-1664
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. CLARA LUISA FAJARDO
Credential : PSYD
Telephone Number : 312-505-7866
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/02/2026

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