Active NPI
Kiara Y Luciano Plaza, PSYD
- Clinical Psychologist
- Ponce, PR
National Provider Identifier
1093584021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 7817
- Practice address
- Urb Punto Oro Calle Laffite
#4325
Ponce, PR 00728 - Phone
- (787) 552-0420
- NPI assigned
- Jan 2, 2024
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 7817 | PR | Primary |
Addresses
Primary practice location
Urb Punto Oro Calle Laffite
#4325
Ponce, PR 00728
Mailing address
Urb Punto Oro Calle Laffite
#4325
Ponce, PR 00728
Phone (787) 552-0420
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240725004396 | PR | Practitioner - Clinical Psychologist | 5799221768 | Practice locations: Ponce, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7817 | PR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1093584021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB PUNTO ORO CALLE LAFFITE",
"address_2": "#4325",
"city": "PONCE",
"state": "PR",
"postal_code": "00728",
"telephone_number": "787-552-0420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "URB PUNTO ORO CALLE LAFFITE",
"address_2": "#4325",
"city": "PONCE",
"state": "PR",
"postal_code": "00728",
"telephone_number": "787-552-0420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCIANO PLAZA",
"first_name": "KIARA",
"middle_name": "Y",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-02",
"last_updated": "2024-07-15",
"certification_date": "2024-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "7817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponce, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.