Active NPI
Brendaliz Diaz-Guevara, PSYD
- Clinical Psychologist
- Vega Alta, PR
National Provider Identifier
1174018659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6047
- Practice address
- 10 Calle Palm Blvd
Vega Alta, PR 00692-9011 - Phone
- (787) 412-8187
- NPI assigned
- Jun 26, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6047 | PR | Primary |
Addresses
Primary practice location
10 Calle Palm Blvd
Vega Alta, PR 00692-9011
Mailing address
10 Calle Palm Blvd
Vega Alta, PR 00692-9011
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530144000000",
"number": "1174018659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 CALLE PALM BLVD",
"city": "VEGA ALTA",
"state": "PR",
"postal_code": "006929011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 CALLE PALM BLVD",
"city": "VEGA ALTA",
"state": "PR",
"postal_code": "006929011",
"telephone_number": "787-412-8187"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ-GUEVARA",
"first_name": "BRENDALIZ",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-26",
"last_updated": "2018-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "6047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vega Alta, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.