Provider Demographics
NPI:1255042784
Name:CRUZ FONSECA, YUANN MEILYN
Entity type:Individual
Prefix:MS
First Name:YUANN
Middle Name:MEILYN
Last Name:CRUZ FONSECA
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:PO BOX 1691
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-1691
Mailing Address - Country:US
Mailing Address - Phone:787-527-5862
Mailing Address - Fax:
Practice Address - Street 1:BARRIO BARRAZAS, SECTOR LOS LOPEZ
Practice Address - Street 2:CARRETERA 853, KILOMETRO 7.9
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-527-5862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6476103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist