Individual
DR. JESSIKA TALAVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
10 CALLE CASIA, VA CARIBBEAN HEALTHCARE SYSTEM, SAN JUAN, PR 00921-3200
(787) 641-3661
Mailing address
151 CALLE CESAR GONZALEZ APT 6803, SAN JUAN, PR 00918-1484
(787) 642-3211
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2816
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2816
PROFESSIONAL LICENSE
PR
Enumeration date
02/16/2007
Last updated
07/08/2007
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