Provider Demographics
NPI:1447581582
Name:OQUENDO, REINALDO (PH,D ABD , PCTFP)
Entity Type:Individual
Prefix:
First Name:REINALDO
Middle Name:
Last Name:OQUENDO
Suffix:
Gender:M
Credentials:PH,D ABD , PCTFP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PRADERA DEL RIO # 3112
Mailing Address - Street 2:ST. RIO BUCANA
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-9111
Mailing Address - Country:US
Mailing Address - Phone:787-458-0161
Mailing Address - Fax:787-799-4148
Practice Address - Street 1:ST. 833 KM. 12.4
Practice Address - Street 2:BO. LOS FRAILES
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00970
Practice Address - Country:US
Practice Address - Phone:787-790-6448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2275103T00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist