Active NPI
Zullyenivette Otero Rodriguez
- Clinical Psychologist
- Ponce, PR
National Provider Identifier
1114650371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 8487
- Practice address
- 388 Zona Ind Reparada 2
Ponce, PR 00716-2347 - Phone
- (787) 840-2575
- NPI assigned
- Jul 6, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | PR | ||
| Clinical Psychologist | 103TC0700X | 8487 | PR | Primary |
Addresses
Primary practice location
388 Zona Ind Reparada 2
Ponce, PR 00716-2347
Mailing address
388 Zona Ind Reparada 2
Ponce, PR 00716-2347
Phone (787) 840-2575
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
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
13 Sect Flores Negron
Aguada, PR 00602-8400
Calle 25 de Julio 35 Prolongacion
Yauco, PR 00698
Calle 25 de Julio 35 Prolongacion
Yauco, PR 00698-3603
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8487 | PR | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goldenminds LLC | Current | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Ponce, PR
- NPI 1558253542
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748908800000",
"number": "1114650371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "388 ZONA IND REPARADA 2",
"city": "PONCE",
"state": "PR",
"postal_code": "007162347",
"telephone_number": "787-840-2575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "388 ZONA IND REPARADA 2",
"city": "PONCE",
"state": "PR",
"postal_code": "007162347",
"telephone_number": "787-840-2575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTERO RODRIGUEZ",
"first_name": "ZULLYENIVETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-06",
"last_updated": "2025-06-03",
"certification_date": "2025-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PR",
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "8487",
"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 Jun 3, 2025; 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.