| Riseup Wellness Pr Llc | |
|
101 Ave San Patricio Ste 1240 Guaynabo PR 00968-3057 | |
| (787) 512-2058 | |
| Not Available |
| Full Name | Riseup Wellness Pr Llc |
|---|---|
| Speciality | Psychologist |
| Location | 101 Ave San Patricio Ste 1240, Guaynabo, Puerto Rico |
| Authorized Official Name and Position | Frances Enid Ostolaza Santiago (CLINICAL PSYCHOLOGIST/ FOUNDER) |
| Authorized Official Contact | 7875122058 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Riseup Wellness Pr Llc 614 Villa Navarra Calle Garcia Ledesma San Juan PR 00924 Ph: (787) 512-2058 | Riseup Wellness Pr Llc 101 Ave San Patricio Ste 1240 Guaynabo PR 00968-3057 Ph: (787) 512-2058 |
| NPI Number | 1366116626 |
|---|---|
| Provider Enumeration Date | 08/02/2021 |
| Last Update Date | 09/17/2021 |
| Certification Date | 09/17/2021 |
| Medicare PECOS PAC ID | 9032501408 |
|---|---|
| Medicare Enrollment ID | O20220114000456 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366116626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0100X | Psychologist - Health Service | (* (Not Available)) | Primary |
| Provider Name | Frances E Ostolaza Santiago |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346913670 PECOS PAC ID: 5395137764 Enrollment ID: I20220114000745 |
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