Provider Demographics
NPI:1194945931
Name:ORRACA, DAMARIS (PSYCOLOGIST)
Entity type:Individual
Prefix:
First Name:DAMARIS
Middle Name:
Last Name:ORRACA
Suffix:
Gender:F
Credentials:PSYCOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 CALLE ITALIA
Mailing Address - Street 2:APT. A
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911-1407
Mailing Address - Country:US
Mailing Address - Phone:787-790-9131
Mailing Address - Fax:787-268-7589
Practice Address - Street 1:20 CALLE PINEIRO
Practice Address - Street 2:URB.PINEIRO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-790-9131
Practice Address - Fax:787-268-7589
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR217103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR96685OtherMCS
PR1433OtherAPS