Provider Demographics
NPI:1801602727
Name:CAPPAS PEREZ, IVANNYS ALEXKA (PSYD)
Entity type:Individual
Prefix:DR
First Name:IVANNYS
Middle Name:ALEXKA
Last Name:CAPPAS PEREZ
Suffix:
Gender:
Credentials:PSYD
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 10832
Mailing Address - Street 2:
Mailing Address - City:GUAYANILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00656-9527
Mailing Address - Country:US
Mailing Address - Phone:787-974-7396
Mailing Address - Fax:
Practice Address - Street 1:BO. MACANA SECTOR LA VEGA CARR 132 KM 5.4
Practice Address - Street 2:
Practice Address - City:PENUELAS
Practice Address - State:PR
Practice Address - Zip Code:00624-0062
Practice Address - Country:US
Practice Address - Phone:787-377-1003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-05
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8119103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical