Provider Demographics
NPI:1518708007
Name:MANZANARES, PATSY KRISTINNA (PSYD)
Entity type:Individual
Prefix:DR
First Name:PATSY
Middle Name:KRISTINNA
Last Name:MANZANARES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:PATSY
Other - Middle Name:KRISTINNA
Other - Last Name:PEREZ-RAMIREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1353 AVE. LUIS VIGOREAUX
Mailing Address - Street 2:PMB 528
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-404-8711
Mailing Address - Fax:
Practice Address - Street 1:7 CALLE WASHINGTON
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920
Practice Address - Country:US
Practice Address - Phone:787-404-8711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7818103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist