Provider Demographics
NPI:1295449551
Name:NAVARRO, VICTORIA (PSYD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:NAVARRO
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 1:3119 37TH ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-5185
Mailing Address - Country:US
Mailing Address - Phone:551-200-0300
Mailing Address - Fax:
Practice Address - Street 1:3119 37TH ST APT 1A
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-5185
Practice Address - Country:US
Practice Address - Phone:551-200-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist