Provider Demographics
NPI:1407612302
Name:SEDA-RAFFUCCI, JULIANA (PHD)
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:SEDA-RAFFUCCI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 AVE PONCE DE LEON APT 612
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909-2056
Mailing Address - Country:US
Mailing Address - Phone:787-383-4545
Mailing Address - Fax:
Practice Address - Street 1:1500 NW NORTH RIVER DR APT 2410
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-2853
Practice Address - Country:US
Practice Address - Phone:787-383-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
PR7870103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist