Provider Demographics
NPI:1598203077
Name:RAPADAS, JUAN (PHD)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:
Last Name:RAPADAS
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 1:144 ASPINALL AVE.
Mailing Address - Street 2:UNIT 201
Mailing Address - City:HAGATNA
Mailing Address - State:GU
Mailing Address - Zip Code:96910
Mailing Address - Country:US
Mailing Address - Phone:671-477-3311
Mailing Address - Fax:
Practice Address - Street 1:144 ASPINALL AVE.
Practice Address - Street 2:UNIT 201
Practice Address - City:HAGATNA
Practice Address - State:GU
Practice Address - Zip Code:96910
Practice Address - Country:US
Practice Address - Phone:671-477-3311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY791103TC0700X
GUCP0023103TC0700X
MPCP0017103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical