Provider Demographics
NPI:1669296901
Name:VAZQUEZ GARCIA, YAMARIS (PSYD MSW)
Entity type:Individual
Prefix:
First Name:YAMARIS
Middle Name:
Last Name:VAZQUEZ GARCIA
Suffix:
Gender:F
Credentials:PSYD MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 8019
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-7358
Mailing Address - Country:US
Mailing Address - Phone:939-272-6658
Mailing Address - Fax:
Practice Address - Street 1:418 CALLE SARGENTO ISRAEL MALARET JUARBE
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641
Practice Address - Country:US
Practice Address - Phone:939-272-6658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR140871041C0700X
PR8310103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical