Provider Demographics
NPI:1851708069
Name:QUIJANO, YSABEL C (PSYD)
Entity Type:Individual
Prefix:
First Name:YSABEL
Middle Name:C
Last Name:QUIJANO
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 1:111 CALLE CECILIO URBINA
Mailing Address - Street 2:COND. PORTAL DE SOFIA ATP 4005
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5958
Mailing Address - Country:US
Mailing Address - Phone:787-667-5303
Mailing Address - Fax:
Practice Address - Street 1:111 CALLE CECILIO URBINA
Practice Address - Street 2:COND. PORTAL DE SOFIA APT 4005
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5958
Practice Address - Country:US
Practice Address - Phone:787-667-5303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-20
Last Update Date:2014-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5534103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical