Individual provider Active NPI

Maria Victoria Garcia, PHD

  • Psychologist
  • San Juan, PR
National Provider Identifier
1053683482
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4115 Issued in PR
Practice address
1801 Ave Ponce de Leon
Santurce Medical Mall
San Juan, PR 00909-1900
Phone
(787) 530-3113
NPI assigned
Feb 1, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4115 PR Primary

Addresses

Primary practice location

1801 Ave Ponce de Leon
Santurce Medical Mall
San Juan, PR 00909-1900

Mailing address

10 Calle Atlantic PL
San Juan, PR 00911-1307

Other identifiers 1

IdentifierTypeStateIssuer
23304550402OtherPRMCS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170809000637 PR Practitioner - Clinical Psychologist 5193015055 Practice locations: San Juan, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4115PRMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1053683482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CALLE ATLANTIC PL",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009111307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 AVE PONCE DE LEON",
            "address_2": "SANTURCE MEDICAL MALL",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009091900",
            "telephone_number": "787-530-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "MARIA",
        "middle_name": "VICTORIA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-01",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "4115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCS",
            "identifier": "23304550402",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.