Provider Demographics
NPI:1083502322
Name:JORDAN COLLAZO, ERIKA FRANCHESCA
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:FRANCHESCA
Last Name:JORDAN COLLAZO
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:URB RAMEY
Mailing Address - Street 2:132 CALLE D
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-1117
Mailing Address - Country:US
Mailing Address - Phone:787-388-7060
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 481 KM 1.7
Practice Address - Street 2:BARRIO COCOS
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678-0000
Practice Address - Country:US
Practice Address - Phone:787-422-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7966103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty