MEDICARE: YESICA CENTENO ALICEA

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	103TC1900X	Counseling Psychologist	5408	PR

General Provider Information

NPI Number	:	1831631019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YESICA CENTENO ALICEA

Provider Business Mailing Address
First Line	:	PLAZA DEGETAU 1
Second Line	:	CALLE SHUFFORD SUITE 109 PMB 202
City	:	CAGUAS
State	:	PR
Zip	:	00727-4977
Country	:	US
Telephone Number	:	939-395-0188
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB. BONNEVILLE HEIGHTS
Second Line	:	CALLE AIBONITO 60
City	:	CAGUAS
State	:	PR
Zip	:	00727-4964
Country	:	US
Telephone Number	:	939-395-0188
Fax Number	:

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

Provider Enumeration Date	:	11/05/2016
Last Update Date	:	10/13/2025

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Directions to “ YESICA CENTENO ALICEA ” Practice Location

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