Active NPI
Mariola Pedraza
- Clinical Psychologist
- Barranquitas, PR
National Provider Identifier
1043644867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4308
- Practice address
- 15 Calle Barcelo
Barranquitas, PR 00794-1710 - Phone
- (787) 617-9583
- NPI assigned
- Aug 28, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4308 | PR | Primary |
Addresses
Primary practice location
15 Calle Barcelo
Barranquitas, PR 00794-1710
Mailing address
15 Calle Barcelo
Barranquitas, PR 00794-1710
Phone (787) 617-9583
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 |
|---|---|---|---|
| 4308 | PR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377648000000",
"number": "1043644867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 CALLE BARCELO",
"city": "BARRANQUITAS",
"state": "PR",
"postal_code": "007941710",
"telephone_number": "787-617-9583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 CALLE BARCELO",
"city": "BARRANQUITAS",
"state": "PR",
"postal_code": "007941710",
"telephone_number": "787-617-9583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDRAZA",
"first_name": "MARIOLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-28",
"last_updated": "2013-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "4308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barranquitas, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.