Individual provider Active NPI

Jesus Del Socorro Salamo, MA

  • Psychologist
  • Fajardo, PR
National Provider Identifier
1164911897
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5361 Issued in PR
Practice address
#14 Antonio R Barcelo Esquina Calle Diego Zalduondo
Fajardo, PR 00738-1025
Phone
(787) 980-8162
NPI assigned
May 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X
Psychologist 103T00000X 5361 PR Primary

Addresses

Primary practice location

#14 Antonio R Barcelo Esquina Calle Diego Zalduondo
Fajardo, PR 00738-1025

Mailing address

#14 Antonio R Barcelo Esquina Calle Diego Zalduondo
Fajardo, PR 00738
Phone (787) 980-8162

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
5361PRMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1164911897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "#14 ANTONIO R BARCELO ESQUINA CALLE DIEGO ZALDUONDO",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "00738",
            "telephone_number": "787-980-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#14 ANTONIO R BARCELO ESQUINA CALLE DIEGO ZALDUONDO",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007381025",
            "telephone_number": "787-980-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAMO",
        "first_name": "JESUS",
        "middle_name": "DEL SOCORRO",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-08",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "5361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fajardo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.