Provider Demographics
NPI:1881558120
Name:CRESPO SOTO, JIXIABEL
Entity type:Individual
Prefix:MS
First Name:JIXIABEL
Middle Name:
Last Name:CRESPO SOTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 16160
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-6527
Mailing Address - Country:US
Mailing Address - Phone:787-618-2265
Mailing Address - Fax:
Practice Address - Street 1:HC 3 BOX 16160
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-6527
Practice Address - Country:US
Practice Address - Phone:787-618-2265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-11
Last Update Date:2025-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8625103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty