Provider Demographics
NPI:1073743464
Name:JUAN, JENSY (MSW)
Entity Type:Individual
Prefix:MISS
First Name:JENSY
Middle Name:
Last Name:JUAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVE LAUREL
Mailing Address - Street 2:HOSPITAL REGIONAL DE BAYAMON
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-7087
Mailing Address - Country:US
Mailing Address - Phone:787-763-7575
Mailing Address - Fax:
Practice Address - Street 1:PLAZA LAUREL
Practice Address - Street 2:HOSPITAL REGIONAL DE BAYAMON
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-3273
Practice Address - Country:US
Practice Address - Phone:787-763-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR172311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR$$$$$$$$$Medicaid