Provider Demographics
NPI:1275089906
Name:BATISTA CLAUDIO, JANNETTE MARIE
Entity Type:Individual
Prefix:
First Name:JANNETTE
Middle Name:MARIE
Last Name:BATISTA CLAUDIO
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 1:1752 CALLE DONCELLA
Mailing Address - Street 2:URB SAN ANTONIO
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728
Mailing Address - Country:US
Mailing Address - Phone:787-354-4143
Mailing Address - Fax:
Practice Address - Street 1:URB. SAN ANTONIO CALLE DONCELLA #1752
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00730
Practice Address - Country:UM
Practice Address - Phone:787-354-4143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR133601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4785627OtherDRIVER'S LICENSE