Active NPI
Jessenia Santiago, PSY.D.
- Clinical Psychologist
- Santa Isabel, PR
National Provider Identifier
1174655419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2696
- Practice address
- Carr,153 KM 7.5
Barrio Paso Seco Sector Useras
Santa Isabel, PR 00757 - Phone
- (787) 479-2257
- Fax
- (787) 845-4531
- NPI assigned
- Mar 12, 2007
- 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 | 2696 | PR | Primary |
Addresses
Primary practice location
Carr,153 KM 7.5
Barrio Paso Seco Sector Useras
Santa Isabel, PR 00757
Mailing address
5504 Paseo Lago Garzas
Extension Lago Horizonte CLL
Coto Laurel, PR 00780-2432
Phone (787) 479-2257
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211129000927 | PR | Practitioner - Psychologist Billing Independently | 4789767724 | Practice locations: Santa Isabel, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Cornerstones Inc | Past | 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 1578658647
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414108800000",
"number": "1174655419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5504 PASEO LAGO GARZAS",
"address_2": "EXTENSION LAGO HORIZONTE CLL",
"city": "COTO LAUREL",
"state": "PR",
"postal_code": "007802432",
"telephone_number": "787-479-2257",
"fax_number": "787-845-4531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR,153 KM 7.5",
"address_2": "BARRIO PASO SECO SECTOR USERAS",
"city": "SANTA ISABEL",
"state": "PR",
"postal_code": "00757",
"telephone_number": "787-479-2257",
"fax_number": "787-845-4531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO",
"first_name": "JESSENIA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-12",
"last_updated": "2014-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "2696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Isabel, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.