Provider Demographics
NPI:1164796173
Name:MARTINEZ SANTOS, YOZIBEL
Entity Type:Individual
Prefix:
First Name:YOZIBEL
Middle Name:
Last Name:MARTINEZ SANTOS
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 1:201 CALLE SILVIO SANTOS
Mailing Address - Street 2:BARRIADA SANDIN
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-6131
Mailing Address - Country:US
Mailing Address - Phone:787-669-6097
Mailing Address - Fax:
Practice Address - Street 1:CALLE 2 SUITE 1
Practice Address - Street 2:URBANIZACION VILLA REAL
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-669-6097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3587103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist