Provider Demographics
NPI:1063210367
Name:VEGA GARCIA, QUETCY ALMA
Entity type:Individual
Prefix:
First Name:QUETCY
Middle Name:ALMA
Last Name:VEGA GARCIA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SHOPPING COURT 65 DE INFANTERIA
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00980-0098
Mailing Address - Country:US
Mailing Address - Phone:939-334-2285
Mailing Address - Fax:
Practice Address - Street 1:URB. COUNTRY CLUB HD 79 CALLE 223
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00980-0098
Practice Address - Country:US
Practice Address - Phone:939-334-2285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR142921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical