Provider Demographics
NPI:1003783051
Name:SOSA, ANGEL J (PHD)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:J
Last Name:SOSA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5890 CALLE TARTAK APT 501B
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-5925
Mailing Address - Country:US
Mailing Address - Phone:787-219-8717
Mailing Address - Fax:
Practice Address - Street 1:5890 CALLE TARTAK APT 501B
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-5925
Practice Address - Country:US
Practice Address - Phone:787-219-8717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6295103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist