Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 1920 | PR |
N | 103TA0700X | Adult Development & Aging Psychologist | 1920 | PR |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1920 | PR |
Y | 103G00000X | Clinical Psychologist | 1920 | PR |
Y | 103TC0700X | Clinical Psychologist | 1920 | PR |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1920 | PR |
N | 103TF0000X | Family Psychologist | 1920 | PR |
N | 103TF0200X | Forensic Psychologist | 1920 | PR |
N | 103TH0004X | Health Psychologist | 1920 | PR |
N | 103TP2701X | Group Psychotherapist | 1920 | PR |
NPI | 1538352398 |
---|---|
Provider Name | Dr. Juan Alberto Nazario |
First Address | San Juan, PR 00923-3137 |
Second Address | Hato Rey, PR 00917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2007 |
Last Update Date | 18/08/2009 |