Provider Demographics
NPI:1376382093
Name:CASTILLO LOZANO, ESTHER VERONICA (PSYD)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:VERONICA
Last Name:CASTILLO LOZANO
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:URB ESTANCIAS DE IMBERY
Mailing Address - Street 2:CALLE VISTULA BUZON 128
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-9718
Mailing Address - Country:US
Mailing Address - Phone:787-216-7074
Mailing Address - Fax:
Practice Address - Street 1:538 AVE JOSE A CEDENO STE 3
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-3962
Practice Address - Country:US
Practice Address - Phone:787-216-7074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7780103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical