1881478477 NPI number — JANEISHKA K ALICEA TOLEDO PSY.D.

Table of content: JANEISHKA K ALICEA TOLEDO PSY.D. (NPI 1881478477)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881478477 NPI number — JANEISHKA K ALICEA TOLEDO PSY.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALICEA TOLEDO
Provider First Name:
JANEISHKA
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PSY.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881478477
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 427
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANGELES
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00611-0427
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-446-4525
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
389 AVE. LOS PATRIOTAS
Provider Second Line Business Practice Location Address:
CARR 111 KM 32.4 BO. LARES
Provider Business Practice Location Address City Name:
LARES
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00669-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-446-4525
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/23/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC1900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6954 . This is a "LICENCIA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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