Active NPI
Yania Ivelisse Enriquez, M. PSY.
- Psychologist
- Guayama, PR
National Provider Identifier
1003134925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3100
- Practice address
- 43 Calle Santiago Palmer N
43 Norte
Guayama, PR 00784-4967 - Phone
- (787) 318-2504
- Fax
- (787) 864-4362
- NPI assigned
- May 17, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3100 | PR | Primary |
Addresses
Primary practice location
43 Calle Santiago Palmer N
43 Norte
Guayama, PR 00784-4967
Mailing address
43 Calle Santiago Palmer N
43 Norte
Guayama, PR 00784-4967
Phone (787) 318-2504
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120321000624 | PR | Practitioner - Psychologist Billing Independently | 0840450219 | Practice locations: Guayama, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3100 | PR | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274054400000",
"number": "1003134925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 CALLE SANTIAGO PALMER N",
"address_2": "43 NORTE",
"city": "GUAYAMA",
"state": "PR",
"postal_code": "007844967",
"telephone_number": "787-318-2504",
"fax_number": "787-864-4362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 CALLE SANTIAGO PALMER N",
"address_2": "43 NORTE",
"city": "GUAYAMA",
"state": "PR",
"postal_code": "007844967",
"telephone_number": "787-318-2504",
"fax_number": "787-864-4362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENRIQUEZ",
"first_name": "YANIA",
"middle_name": "IVELISSE",
"credential": "M. PSY.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-17",
"last_updated": "2010-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PR",
"license": "3100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Guayama, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.