| Clinica Psicoterapeutica Sistemica E Integrativa, Csp | |
|
Calle Guayama #10 Bo Pueblo Salinas PR 00751 | |
| (787) 677-7704 | |
| Not Available |
| Full Name | Clinica Psicoterapeutica Sistemica E Integrativa, Csp |
|---|---|
| Speciality | Psychologist |
| Location | Calle Guayama #10, Salinas, Puerto Rico |
| Authorized Official Name and Position | Janis J. Diaz (PRESIDENTA) |
| Authorized Official Contact | 7876777704 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Psicoterapeutica Sistemica E Integrativa, Csp Po Box 414 Aguirre PR 00704-0414 Ph: (787) 677-7704 | Clinica Psicoterapeutica Sistemica E Integrativa, Csp Calle Guayama #10 Bo Pueblo Salinas PR 00751 Ph: (787) 677-7704 |
| NPI Number | 1972879823 |
|---|---|
| Provider Enumeration Date | 03/26/2012 |
| Last Update Date | 10/08/2012 |
| Medicare PECOS PAC ID | 0042462442 |
|---|---|
| Medicare Enrollment ID | O20121211000407 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972879823 | NPI | - | NPPES |
| 1366712226 | Other | PR | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 4104 (Puerto Rico) | Primary |
| Provider Name | Janis J Diaz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366712226 PECOS PAC ID: 2567623747 Enrollment ID: I20120416000227 |
| Provider Name | Vilma A Roque Nieves |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659001568 PECOS PAC ID: 1951784974 Enrollment ID: I20220823003783 |
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