Provider Demographics
NPI:1770203085
Name:MENDEZ GOMEZ, YEIDEE LEE (PSYD)
Entity type:Individual
Prefix:
First Name:YEIDEE
Middle Name:LEE
Last Name:MENDEZ GOMEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:YEIDEE
Other - Middle Name:LEE
Other - Last Name:MENDEZ GOMEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:HC 2 BOX 13597
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-9751
Mailing Address - Country:US
Mailing Address - Phone:787-510-1993
Mailing Address - Fax:
Practice Address - Street 1:URB. VILLA BLANCA
Practice Address - Street 2:C- AQUAMARINA #68
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-744-4447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6388103T00000X, 103TC1900X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling