Provider Demographics
NPI:1922745132
Name:MOLINA ORITZ, JOHANA K
Entity Type:Individual
Prefix:MRS
First Name:JOHANA
Middle Name:K
Last Name:MOLINA ORITZ
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 1:500 PASEO 6
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-1205
Mailing Address - Country:US
Mailing Address - Phone:787-403-6582
Mailing Address - Fax:
Practice Address - Street 1:500 PASEO 6
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-1205
Practice Address - Country:US
Practice Address - Phone:787-403-6582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23684104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker