Provider Demographics
NPI:1609164466
Name:ALVARADO-MENDEZ, JOSE ANTONIO (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ANTONIO
Last Name:ALVARADO-MENDEZ
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:H9 CALLE 8
Mailing Address - Street 2:EL MIRADOR DE CUPEY
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7575
Mailing Address - Country:US
Mailing Address - Phone:787-439-3598
Mailing Address - Fax:
Practice Address - Street 1:H9 CALLE 8
Practice Address - Street 2:EL MIRADOR DE CUPEY
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-7575
Practice Address - Country:US
Practice Address - Phone:787-439-3598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3980103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist