Provider Demographics
NPI:1407259369
Name:LUNA RODRIGUEZ, SANDRA L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:L
Last Name:LUNA RODRIGUEZ
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 SANTA CRUZ #68, TORRE SAN PABLO
Mailing Address - Street 2:OFICINA 606
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-627-4895
Mailing Address - Fax:
Practice Address - Street 1:TORRE SAN PABLO, CALLE SANTA CRUZ #68
Practice Address - Street 2:OFICINA 606
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-909-5359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-06
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PR6073103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health