Provider Demographics
NPI:1538774427
Name:CRUZ HERNANDEZ, YOMAYRA I (PSY D)
Entity type:Individual
Prefix:
First Name:YOMAYRA
Middle Name:
Last Name:CRUZ HERNANDEZ
Suffix:I
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URBANIZACION LOS CAOBOS CALLE GUARAGUAO
Mailing Address - Street 2:1729
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:787-372-1462
Mailing Address - Fax:787-848-6334
Practice Address - Street 1:THE RENAL CENTER OF MANATI
Practice Address - Street 2:CARR. 2 KM. 47.7
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7335103TC0700X
10337104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7335OtherPSICOLIGIA CLINICA