Provider Demographics
NPI:1023565710
Name:PSICOMEDICA DEL OESTE CSP
Entity type:Organization
Organization Name:PSICOMEDICA DEL OESTE CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:R
Authorized Official - Last Name:TAPIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1787-376-7589
Mailing Address - Street 1:111 URBANIZACION EL VALLE ALAMO
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-2502
Mailing Address - Country:US
Mailing Address - Phone:787-376-7589
Mailing Address - Fax:
Practice Address - Street 1:111 URBANIZACION EL VALLE ALAMO
Practice Address - Street 2:
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667-2502
Practice Address - Country:US
Practice Address - Phone:787-376-7589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-09
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2024103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty