Provider Demographics
NPI:1427134899
Name:CASTILLO VELIZ, ESMERALDA (PSYD)
Entity type:Individual
Prefix:
First Name:ESMERALDA
Middle Name:
Last Name:CASTILLO VELIZ
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:DM16 CALLE COLINAS
Mailing Address - Street 2:VALLE VERDE 3
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-3355
Mailing Address - Country:US
Mailing Address - Phone:787-210-7151
Mailing Address - Fax:787-760-7064
Practice Address - Street 1:359 CALLE SAN CLAUDIO
Practice Address - Street 2:OFICINA 206, CUPEY PROFESSIONAL MALL
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00926-9907
Practice Address - Country:US
Practice Address - Phone:787-760-7064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2166103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2845OtherAPS
PR542478OtherFHC HEALTH SYSTEMS
PR219039OtherPREFERRED HEALTH
PR57256CAOtherTRIPLE S