Provider Demographics
NPI:1215307996
Name:ASTACIO RUIZ, ARACELYS (PSYD)
Entity type:Individual
Prefix:
First Name:ARACELYS
Middle Name:
Last Name:ASTACIO RUIZ
Suffix:
Gender:F
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:URB VALLE REAL
Mailing Address - Street 2:CALLE ISABEL 25002
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610
Mailing Address - Country:US
Mailing Address - Phone:787-673-0685
Mailing Address - Fax:
Practice Address - Street 1:VALLEY HILLS PROFESSIONAL CENTER
Practice Address - Street 2:LOCAL #5 CARR 402 KM 2.9
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-400-5484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3978103TC1900X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling