Provider Demographics
NPI:1114071263
Name:VALCARCEL, CARLOS RAFAEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:RAFAEL
Last Name:VALCARCEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2-B ST.
Mailing Address - Street 2:705 VILLAS DE MONTECARLO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924
Mailing Address - Country:US
Mailing Address - Phone:787-761-5889
Mailing Address - Fax:787-293-1234
Practice Address - Street 1:MONTECARLO AVE. 705 VILLAS DE MONTECARLO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-761-5889
Practice Address - Fax:787-293-1234
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1586103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent