Provider Demographics
NPI:1457062978
Name:LANDRAU, ALESSANDRA (PHD)
Entity Type:Individual
Prefix:MISS
First Name:ALESSANDRA
Middle Name:
Last Name:LANDRAU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND PLAZA 20
Mailing Address - Street 2:603 CALLE HIPODROMO APT. 406
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909
Mailing Address - Country:US
Mailing Address - Phone:787-354-4223
Mailing Address - Fax:
Practice Address - Street 1:712 AVE PONCE DE LEON
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-4518
Practice Address - Country:US
Practice Address - Phone:787-908-8840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7556103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist