Provider Demographics
NPI:1609184001
Name:GONZALEZ, DELIA PATRICIA (PSY D)
Entity Type:Individual
Prefix:DR
First Name:DELIA
Middle Name:PATRICIA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1622 CALLE CAROLINA
Mailing Address - Street 2:CITY MANORS, 1-2
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00912-3804
Mailing Address - Country:US
Mailing Address - Phone:787-529-3483
Mailing Address - Fax:
Practice Address - Street 1:1622 CALLE CAROLINA
Practice Address - Street 2:CITY MANORS, 1-3
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912-3804
Practice Address - Country:US
Practice Address - Phone:787-722-6734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1092103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical