Provider Demographics
NPI:1124527486
Name:ALCALA PEREZ, DAVID JESUS (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JESUS
Last Name:ALCALA PEREZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UU1 CALLE 39
Mailing Address - Street 2:PMB 224 SANTA JUANITA MAIL STATION
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-717-7005
Mailing Address - Fax:
Practice Address - Street 1:PONCE DE LEON AVENUE
Practice Address - Street 2:416 UNION PLAZA BUILDING SUITE 912
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-717-7005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-01
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5339103TC1900X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral