Provider Demographics
NPI:1548064215
Name:MONCLOVA RODRIGUEZ, ALEJANDRA M (MSCA)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:M
Last Name:MONCLOVA RODRIGUEZ
Suffix:
Gender:
Credentials:MSCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. METROPOLIS CALLE 46 2T-21 CAROLINA
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-449-8573
Mailing Address - Fax:
Practice Address - Street 1:CUPEY PROFESSIONAL MALL 359 C. SAN CAUDIO
Practice Address - Street 2:
Practice Address - City:SAN JAUN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-449-8573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
8204103TB0200X
PR8204103TS0200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool