Provider Demographics
NPI:1952521254
Name:CORTES, YOLANDA ACEVEDO (PHD)
Entity Type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:ACEVEDO
Last Name:CORTES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:YOLANDA
Other - Middle Name:ACEVEDO
Other - Last Name:CORTES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:HAMACA F-6, BRISAS DE MONTECASINOS, TOA ALTA,PR
Mailing Address - Street 2:#605, BRISAS DE MONTECASINOS
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-251-3477
Mailing Address - Fax:787-759-6686
Practice Address - Street 1:414 AVE BARBOSA
Practice Address - Street 2:AVE. BARBOSA 414, TERCER PISO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-4306
Practice Address - Country:US
Practice Address - Phone:787-282-7618
Practice Address - Fax:787-759-6686
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1107103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical