Provider Demographics
NPI:1265926737
Name:QUINTANA MARTINEZ, SOMARI (PSYD)
Entity type:Individual
Prefix:DR
First Name:SOMARI
Middle Name:
Last Name:QUINTANA MARTINEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C29 CALLE AYMACO
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-7730
Mailing Address - Country:US
Mailing Address - Phone:787-980-7212
Mailing Address - Fax:
Practice Address - Street 1:86 CALLE DR RUFO
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3723
Practice Address - Country:US
Practice Address - Phone:787-504-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-19
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6114103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6114OtherPSYCHOLOGY LICENSE