Active NPI
Liza M Rodriguez Rodriguez, PSYD
- Clinical Psychologist
- Bayamon, PR
National Provider Identifier
1174763486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4668
- Practice address
- 302 Carr 168 # Urb Riverview Calle 17
# T-6
Bayamon, PR 00961-3864 - Phone
- (939) 645-6463
- NPI assigned
- Feb 26, 2009
- 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 | 4668 | PR | Primary |
Addresses
Primary practice location
302 Carr 168 # Urb Riverview Calle 17
# T-6
Bayamon, PR 00961-3864
Mailing address
Urb. Riverview
Calle 17 T-6
Bayamon, PR 00961-0000
Phone (939) 645-6463
Other practice location 1
Carr #2 KM 57.8
Cruce Davila
Barceloneta, PR 00617-2045
Phone (787) 846-4412 ext. 1061
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4668 | Medicaid | PR |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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.
-
- Federally Qualified Health Center (FQHC)
- Barceloneta, PR
- NPI 1972509842
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1174763486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB. RIVERVIEW",
"address_2": "CALLE 17 T-6",
"city": "BAYAMON",
"state": "PR",
"postal_code": "009610000",
"telephone_number": "939-645-6463",
"fax_number": "787-846-7410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 CARR 168 # URB RIVERVIEW CALLE 17",
"address_2": "# T-6",
"city": "BAYAMON",
"state": "PR",
"postal_code": "009613864",
"telephone_number": "939-645-6463"
}
],
"practiceLocations": [
{
"address_1": "Carr #2 KM 57.8",
"address_2": "Cruce Davila",
"address_purpose": "LOCATION",
"city": "Barceloneta",
"state": "PR",
"postal_code": "006172045",
"country_code": "US",
"telephone_number": "787-846-4412 x1061",
"fax_number": "787-846-7410",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RODRIGUEZ RODRIGUEZ",
"first_name": "LIZA",
"middle_name": "M",
"name_prefix": "Miss",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-26",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "4668",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4668",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bayamon, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.