Provider Demographics
NPI:1740592542
Name:CONCEPCION CARRERO, ANA JESSICA (PSYD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:JESSICA
Last Name:CONCEPCION CARRERO
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:C1 N39
Mailing Address - Street 2:URB. FLAMBOYANES
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602
Mailing Address - Country:US
Mailing Address - Phone:787-487-9086
Mailing Address - Fax:
Practice Address - Street 1:EDIFICIO AGUADA COMPLEX
Practice Address - Street 2:SUITE 5 CARR 115
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-487-9086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3741103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical