Provider Demographics
NPI:1467403907
Name:GAUD, LUZ N (PSYD)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:N
Last Name:GAUD
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 1:44 CALLE SAN IGNACIO
Mailing Address - Street 2:URB LIRIOS CALA
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-8604
Mailing Address - Country:US
Mailing Address - Phone:787-236-3545
Mailing Address - Fax:
Practice Address - Street 1:CALLE ESTEBAN PADILLA EDIF 101
Practice Address - Street 2:OFICINA 3
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-785-3819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR672103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR84125Medicare ID - Type UnspecifiedDOCTORAL CLINICAL PSYCHOL