Active NPI
Tayliss Irizarry
- Psychologist
- San German, PR
National Provider Identifier
1003204579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3571
- Practice address
- 74 Onix
Urb. Pedregal
San German, PR 00683-2529 - Phone
- (787) 210-4679
- NPI assigned
- Jan 6, 2015
- 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 | 3571 | PR | Primary |
Addresses
Primary practice location
74 Onix
Urb. Pedregal
San German, PR 00683-2529
Mailing address
74 Onix
Urbanizacion Pedregal
San German, PR 00683-2529
Phone (787) 210-4679
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3571 | PR | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420502400000",
"number": "1003204579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 ONIX",
"address_2": "URBANIZACION PEDREGAL",
"city": "SAN GERMAN",
"state": "PR",
"postal_code": "006832529",
"telephone_number": "787-210-4679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74 ONIX",
"address_2": "URB. PEDREGAL",
"city": "SAN GERMAN",
"state": "PR",
"postal_code": "006832529",
"telephone_number": "787-210-4679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRIZARRY",
"first_name": "TAYLISS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-06",
"last_updated": "2015-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PR",
"license": "3571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San German, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.