Provider Demographics
NPI:1578014379
Name:CEDANO, YASSIRA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:YASSIRA
Middle Name:M
Last Name:CEDANO
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:CALLE GONZALO RIVERA ORTEGA
Mailing Address - Street 2:COND. LAS TORRES SUR, SUITE 2B
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-349-2718
Mailing Address - Fax:
Practice Address - Street 1:CALLE GONZALO RIVERA ORTEGA
Practice Address - Street 2:COND. LAS TORRES SUR, SUITE 2B
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-349-2718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-18
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5628103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical