Individual provider Active NPI

Sheila Mangual-Monzon, PSY.D

  • Clinical Psychologist
  • Canovanas, PR
National Provider Identifier
1174791487
Registry record updated Nov 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3003 Issued in PR
Practice address
65 Calle Calderon Mujica
Canovanas, PR 00729-3127
Phone
(787) 473-6024
NPI assigned
Feb 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3003 PR Primary

Addresses

Primary practice location

65 Calle Calderon Mujica
Canovanas, PR 00729-3127

Mailing address

PO Box 1485
Canovanas, PR 00729-1485
Phone (787) 473-6024

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200923000033 PR Practitioner - Clinical Psychologist 7618396706 Practice locations: Canovanas, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3003PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541116800000",
    "number": "1174791487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1485",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "007291485",
            "telephone_number": "787-473-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 CALLE CALDERON MUJICA",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "007293127",
            "telephone_number": "787-473-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUAL-MONZON",
        "first_name": "SHEILA",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-20",
        "last_updated": "2018-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canovanas, PR

Sources for this page

Verify at the official NPI Registry.