Provider Demographics
NPI:1275811838
Name:NEGRON, ANGEMARIS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANGEMARIS
Middle Name:
Last Name:NEGRON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 PASEO DE LA REINA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2417
Mailing Address - Country:US
Mailing Address - Phone:787-237-0407
Mailing Address - Fax:
Practice Address - Street 1:1403 PASEO DE LA REINA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2417
Practice Address - Country:US
Practice Address - Phone:787-237-0407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4023103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical