Julio Gonzalez del Valle, PHD

Individual provider Active NPI Clinical Psychologist · Caguas, PR

NPI 1386760940 · NPPES record last updated Apr 10, 2017

Key facts

NPI
1386760940
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
1715 (PR)
Practice address
106 Ave Jose Mercado
Calle Padial
Caguas, PR 00725-9743
Phone
(787) 642-1614
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20051206000022 PR Practitioner - Clinical Psychologist 4688694623 Practice locations: Caguas, PR

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1715 PR Yes

Addresses

Primary practice location

106 Ave Jose Mercado
Calle Padial
Caguas, PR 00725-9743

Mailing address

HC-03 Box 41463
Caguas, PR 00725-9743
Phone (787) 642-1614

Other providers in Caguas, PR

All providers in Caguas, PR · Clinical Psychologist in Puerto Rico

Sources for this page

Verify at the official NPI Registry.