Provider Demographics
NPI:1467128827
Name:VINCENTY, ERICKA FRANCHESCA (PHD)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:FRANCHESCA
Last Name:VINCENTY
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:COLINAS DE FAIRVIEW
Mailing Address - Street 2:CALLE 221 4S35
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-8226
Mailing Address - Country:US
Mailing Address - Phone:787-215-2197
Mailing Address - Fax:
Practice Address - Street 1:74 CALLE SANTA CRUZ STE 606
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7056
Practice Address - Country:US
Practice Address - Phone:787-909-5359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6158103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical