Provider Demographics
NPI:1205014768
Name:TRUJILLO SANTOS, NATYA (PHD)
Entity Type:Individual
Prefix:DR
First Name:NATYA
Middle Name:
Last Name:TRUJILLO SANTOS
Suffix:
Gender:F
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:PMB 773, 497 AVENUE EMILIANO POL
Mailing Address - Street 2:URB. LAS CUMBRES #497
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-616-5449
Mailing Address - Fax:
Practice Address - Street 1:497 AVE EMILIANO POL
Practice Address - Street 2:URB. LAS CUMBRES #497
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5602
Practice Address - Country:US
Practice Address - Phone:787-616-5449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2705103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical