Provider Demographics
NPI:1891245155
Name:MENDEZ, TARA TORRES (PSYD)
Entity type:Individual
Prefix:MISS
First Name:TARA
Middle Name:TORRES
Last Name:MENDEZ
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:VA CARIBBEAN HEALTHCARE SYSTEM, PSYCHOLOGY (116B)
Mailing Address - Street 2:10 CALLE CASIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-9368
Mailing Address - Country:US
Mailing Address - Phone:787-641-7582
Mailing Address - Fax:
Practice Address - Street 1:VA CARIBBEAN HEALTHCARE SYSTEM
Practice Address - Street 2:10 CALLE CASIA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR401807OtherFQHC
PR82747Medicare PIN