Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | ||
N | 103G00000X | Clinical Psychologist | 4104 | PR |
N | 103TC0700X | Clinical Psychologist | 4104 | PR |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 4104 | PR |
N | 103TA0700X | Adult Development & Aging Psychologist | 4104 | PR |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 4104 | PR |
Y | 103G00000X | Clinical Psychologist | 4104 | PR |
Y | 103TC0700X | Clinical Psychologist | 4104 | PR |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 4104 | PR |
N | 103TF0000X | Family Psychologist | 4104 | PR |
N | 103TF0200X | Forensic Psychologist | 4104 | |
N | 103TH0100X | Health Service | 4104 | |
N | 103TM1800X | Intellectual & Developmental Disabilities | 4104 | PR |
N | 103TP0814X | Psychoanalysis | 4104 | |
N | 103TP2701X | Group Psychotherapist | 4104 | |
N | 103TR0400X | Rehabilitation Psychologist | 4104 |
NPI | 1366712226 |
---|---|
Provider Name | Janis J Diaz |
First Address | Aguirre, PR 00704-0414 |
Second Address | Salinas, PR 00751-3314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2012 |
Last Update Date | 14/02/2012 |