Provider Demographics
NPI:1538238092
Name:VEGA TORRES, ISAMAR (PSY)
Entity type:Individual
Prefix:MRS
First Name:ISAMAR
Middle Name:
Last Name:VEGA TORRES
Suffix:
Gender:F
Credentials:PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 CALLE DEL CARMEN W
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-4717
Mailing Address - Country:US
Mailing Address - Phone:787-860-3555
Mailing Address - Fax:
Practice Address - Street 1:55 CALLE DEL CARMEN W
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-4717
Practice Address - Country:US
Practice Address - Phone:787-860-3558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2615103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist