Lourdes Fuentes Fonseca, PSY D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2108 Issued in PR

Practice address

301 Calle Recinto S
Condominio Gallardo Ofic 401-a
San Juan, PR 00901-1960

Phone

(787) 365-9572

Fax

(787) 725-5886

NPI assigned

May 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Lourdes Fuentes Rolon Other name

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

Specialty

Clinical Psychologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1083836936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9023252",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009023252",
            "telephone_number": "787-365-9572",
            "fax_number": "787-725-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 CALLE RECINTO S",
            "address_2": "CONDOMINIO GALLARDO OFIC 401-A",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009011960",
            "telephone_number": "787-365-9572",
            "fax_number": "787-725-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES FONSECA",
        "first_name": "LOURDES",
        "name_prefix": "Dr.",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "2108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APS HUMANA",
            "identifier": "2466",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FHC",
            "identifier": "500950",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST MEDICAL",
            "identifier": "P559",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "56610",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOURDES",
            "last_name": "ROLON",
            "middle_name": "FUENTES",
            "credential": "PSY D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Natasha Lizette Frontera
• Sebastian Frontera, MS
• Walter R Frontera, MD, PHD
• Enrique Frontero Jr., DMD
• Bryan Alexander Fuentes Arias, MSW
• Josie Danelli Fuentes Gutierrez, M.D.
• Fuentes Medical Center Corp
• Milka Yaditza Fuentes Osorio, CCSW
• Rebeca Fuentes Rodriguez, M.D.
• Rebeca Fuentes Ruiz, SOCIAL WORKER

• Psychologist in San Juan, PR
• Providers in San Juan, PR by specialty
• Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.