Provider Demographics
NPI:1649501487
Name:CAEZ, KAREN L (PHD)
Entity type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:L
Last Name:CAEZ
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:PO BOX 6358
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726
Mailing Address - Country:US
Mailing Address - Phone:787-286-9292
Mailing Address - Fax:
Practice Address - Street 1:BONNEVILLE HEIGHTS #25 OFIC. #2
Practice Address - Street 2:AVE. DEGETAU
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727
Practice Address - Country:US
Practice Address - Phone:787-286-9292
Practice Address - Fax:787-286-9292
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3506103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRER670AMedicare PIN