Provider Demographics
NPI:1457445090
Name:GARCIA-CASTANO, FERNANDO (PHD)
Entity Type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:
Last Name:GARCIA-CASTANO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 DE DIEGO AVENUE
Mailing Address - Street 2:PLAZA SAN FRANCISCO, SUITE 105
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:787-250-7414
Mailing Address - Fax:787-759-5093
Practice Address - Street 1:201 DE DIEGO AVENUE
Practice Address - Street 2:PLAZA SAN FRANCISCO, SUITE 105
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-250-7414
Practice Address - Fax:787-759-5093
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1028103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR84176OtherTRIPLE S