Active NPI
Keyla M Rodriguez, PHD
- Clinical Psychologist
- Mayaguez, PR
National Provider Identifier
1164045316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 006565
- Practice address
- 790 Carr 349
Mayaguez, PR 00680-8326 - Phone
- (787) 240-6942
- NPI assigned
- May 22, 2020
- 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 | 006565 | PR | Primary |
Addresses
Primary practice location
790 Carr 349
Mayaguez, PR 00680-8326
Mailing address
790 Carr 349
Mayaguez, PR 00680-8326
Phone (787) 240-6942
Other practice location 1
455 Gonzalez Clemente Ave
Val Harbour Plaza Suite 216
Mayaguez, PR 00680
Phone (787) 240-6942
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006565 | PR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590105600000",
"number": "1164045316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 CARR 349",
"city": "MAYAGUEZ",
"state": "PR",
"postal_code": "006808326",
"telephone_number": "787-240-6942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 CARR 349",
"city": "MAYAGUEZ",
"state": "PR",
"postal_code": "006808326",
"telephone_number": "787-240-6942"
}
],
"practiceLocations": [
{
"address_1": "455 Gonzalez Clemente Ave",
"address_2": "Val Harbour Plaza Suite 216",
"address_purpose": "LOCATION",
"city": "Mayaguez",
"state": "PR",
"postal_code": "00680",
"country_code": "US",
"telephone_number": "787-240-6942",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "KEYLA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-22",
"last_updated": "2020-05-22",
"certification_date": "2020-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "006565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mayaguez, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.