Provider Demographics
NPI:1841442522
Name:CRUZ MORALES, YESENIA (MA)
Entity type:Individual
Prefix:
First Name:YESENIA
Middle Name:
Last Name:CRUZ MORALES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE GAZTAMBIDE 121
Mailing Address - Street 2:URB LA ESTANCIA
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-2285
Mailing Address - Country:US
Mailing Address - Phone:399-323-0687
Mailing Address - Fax:
Practice Address - Street 1:120 CALLE PAVIA FERNANDEZ
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-2285
Practice Address - Country:US
Practice Address - Phone:939-323-0687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103T00000XBehavioral Health & Social Service ProvidersPsychologist