Individual provider Active NPI

Royce N Jalazo, PSYD

  • Clinical Psychologist
  • Ft Lauderdale, FL
National Provider Identifier
1093986416
Registry record updated Nov 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 7671 Issued in FL
Practice address
1975 E Sunrise Blvd
Suite 532
Ft Lauderdale, FL 33304-1433
Phone
(954) 232-7092
Fax
(954) 208-3400
NPI assigned
Mar 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY 7671 FL Primary

Addresses

Primary practice location

1975 E Sunrise Blvd
Suite 532
Ft Lauderdale, FL 33304-1433

Mailing address

1975 E Sunrise Blvd
Suite 532
Ft Lauderdale, FL 33304-1433
Phone (954) 232-7092

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY 7671FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Clinical & Forensic Psychology Inc Clinical PastSince Sep 10, 2004 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1093986416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 E SUNRISE BLVD",
            "address_2": "SUITE 532",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041433",
            "telephone_number": "954-232-7092",
            "fax_number": "954-208-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 E SUNRISE BLVD",
            "address_2": "SUITE 532",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041433",
            "telephone_number": "954-232-7092",
            "fax_number": "954-208-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALAZO",
        "first_name": "ROYCE",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-13",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 7671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.