Provider Demographics
NPI:1891354825
Name:PANTOJAS, YARITZA
Entity Type:Individual
Prefix:
First Name:YARITZA
Middle Name:
Last Name:PANTOJAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 3 #63
Mailing Address - Street 2:BARRIO PALMAS
Mailing Address - City:CATANO
Mailing Address - State:PR
Mailing Address - Zip Code:00962
Mailing Address - Country:US
Mailing Address - Phone:787-661-0332
Mailing Address - Fax:
Practice Address - Street 1:CALLE 3 #63
Practice Address - Street 2:BARRIO PALMAS
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962
Practice Address - Country:US
Practice Address - Phone:787-661-0332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13552104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker