Provider Demographics
NPI:1700128550
Name:CEDENO, ALEXANDER (PSY D)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:CEDENO
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PARCELAS AMALIA MARIN
Mailing Address - Street 2:CALLE DORADO #4821
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-1003
Mailing Address - Country:US
Mailing Address - Phone:787-447-1299
Mailing Address - Fax:
Practice Address - Street 1:4821 CALLE DORADO
Practice Address - Street 2:AMALIA MARIN
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-1003
Practice Address - Country:US
Practice Address - Phone:787-447-1299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2021-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7135103TC0700X
PRTAC-II-11-48-2563101YA0400X
PRTTC-II-11-48-2563106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist