Provider Demographics
NPI:1760524490
Name:VELAZQUEZ, JESSICA (M PSY)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:VELAZQUEZ
Suffix:
Gender:F
Credentials:M PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BARRIO MONTONES 3 CARR917
Mailing Address - Street 2:HC-02 BOX 7180
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771
Mailing Address - Country:US
Mailing Address - Phone:787-733-6539
Mailing Address - Fax:
Practice Address - Street 1:BARRIO MONTONES 3 CARR917
Practice Address - Street 2:HC-02 BOX 7180
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771
Practice Address - Country:US
Practice Address - Phone:787-733-6539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist