Provider Demographics
NPI:1790888121
Name:CRUZ, CESAR E (MSW, TACIII, PHD(C))
Entity Type:Individual
Prefix:MR
First Name:CESAR
Middle Name:E
Last Name:CRUZ
Suffix:
Gender:M
Credentials:MSW, TACIII, PHD(C)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB LAS MONJITAS
Mailing Address - Street 2:207 MONASTERIO ST
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-3907
Mailing Address - Country:US
Mailing Address - Phone:787-202-8225
Mailing Address - Fax:
Practice Address - Street 1:URB LAS MONJITAS
Practice Address - Street 2:207 MONASTERIO ST
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-3907
Practice Address - Country:US
Practice Address - Phone:787-202-8225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR05-20-6983101YA0400X
PR83201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)