Provider Demographics
NPI:1841976388
Name:CARTAGENA ALVARADO, JUAN JOSE (PSYD)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:JOSE
Last Name:CARTAGENA ALVARADO
Suffix:
Gender:M
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 14757
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-9742
Mailing Address - Country:US
Mailing Address - Phone:787-360-6052
Mailing Address - Fax:
Practice Address - Street 1:PR 14 KM 24.6 BO LOS LLANOS
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-9742
Practice Address - Country:US
Practice Address - Phone:787-360-6052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6469103T00000X, 103TC1900X
103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103T00000XBehavioral Health & Social Service ProvidersPsychologist