Provider Demographics
NPI:1497004170
Name:BAERGA, KALITZA (PHD)
Entity Type:Individual
Prefix:DR
First Name:KALITZA
Middle Name:
Last Name:BAERGA
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 1:317B CALLE COLUMBIA
Mailing Address - Street 2:UNIVERSITY GARDENS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-4019
Mailing Address - Country:US
Mailing Address - Phone:787-287-7030
Mailing Address - Fax:787-287-4880
Practice Address - Street 1:317B CALLE COLUMBIA
Practice Address - Street 2:UNIVERSITY GARDENS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-4019
Practice Address - Country:US
Practice Address - Phone:787-287-7030
Practice Address - Fax:787-287-4880
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1885103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical