Provider Demographics
NPI:1326607920
Name:BESU PASTOR, FABIO EUGENIO
Entity Type:Individual
Prefix:
First Name:FABIO
Middle Name:EUGENIO
Last Name:BESU PASTOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 CALLE PERAL EDIFICIO LA PALMA
Mailing Address - Street 2:SUITE 3-E
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-948-8428
Mailing Address - Fax:787-935-7163
Practice Address - Street 1:UC DAVIS EARLY PSYCHOSIS PROGRAM
Practice Address - Street 2:2230 STOCKTON BLVD
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-734-3350
Practice Address - Fax:916-734-7539
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist