Provider Demographics
NPI:1255605168
Name:ORENGO, BETHZAIDA (DOCTORATE IN CLINICA)
Entity type:Individual
Prefix:MRS
First Name:BETHZAIDA
Middle Name:
Last Name:ORENGO
Suffix:
Gender:F
Credentials:DOCTORATE IN CLINICA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 560673
Mailing Address - Street 2:
Mailing Address - City:GUAYANILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00656
Mailing Address - Country:US
Mailing Address - Phone:787-835-5394
Mailing Address - Fax:787-841-6747
Practice Address - Street 1:FAGOT AVENUE #3260
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730
Practice Address - Country:US
Practice Address - Phone:787-385-9752
Practice Address - Fax:787-841-6747
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-24
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2573103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical