Provider Demographics
NPI:1326361890
Name:ESPADA, ANEL JULISSA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANEL
Middle Name:JULISSA
Last Name:ESPADA
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:CALLE FELIPE BONILLA # 3
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751
Mailing Address - Country:US
Mailing Address - Phone:787-638-7739
Mailing Address - Fax:
Practice Address - Street 1:16 CALLE RAFAEL OCASIO
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751-3240
Practice Address - Country:US
Practice Address - Phone:787-824-1934
Practice Address - Fax:787-824-4123
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2647103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical