Provider Demographics
NPI:1124570734
Name:VALSEGA, EDUARDO (PHD)
Entity Type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:
Last Name:VALSEGA
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:O7 CALLE 10
Mailing Address - Street 2:URB. BERWIND ESTATES
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-5731
Mailing Address - Country:US
Mailing Address - Phone:787-617-1364
Mailing Address - Fax:
Practice Address - Street 1:1848 CALLE GLASGOW
Practice Address - Street 2:COLLEGE PARK
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-4813
Practice Address - Country:US
Practice Address - Phone:787-617-1364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-30
Last Update Date:2016-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5737103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical