Provider Demographics
NPI:1760771489
Name:JONES-GARRASTEGUI, WILLIAM A
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:A
Last Name:JONES-GARRASTEGUI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 CALLE GEORGETOWN
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-4809
Mailing Address - Country:US
Mailing Address - Phone:787-764-9811
Mailing Address - Fax:
Practice Address - Street 1:GL14 AVE CAMPO RICO
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-2675
Practice Address - Country:US
Practice Address - Phone:787-276-2545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2862103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling