Provider Demographics
NPI:1205133766
Name:FERNANDEZ, ZAIDA N (PSICOLOGA)
Entity type:Individual
Prefix:MRS
First Name:ZAIDA
Middle Name:N
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:PSICOLOGA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BOULEVARD MONROIG
Mailing Address - Street 2:COND. LAGO VISTA II - BUZON 210
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4425
Mailing Address - Country:US
Mailing Address - Phone:787-579-4850
Mailing Address - Fax:
Practice Address - Street 1:COND LAGO VISTA II # 210
Practice Address - Street 2:200 BOULEVARD MONROIG
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-4434
Practice Address - Country:US
Practice Address - Phone:787-579-4850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3873103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling