Edesther Alejandra Caballero-Gippson

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3988 Issued in PR

Practice address

PMB 410 de Diego Ave 89
Suite 105
San Juan, PR 00927

Phone

(787) 530-6633

NPI assigned

Jun 24, 2011

Last updated

Jul 8, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Caballero Gippson Former name

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

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elders of Puerto Rico PSCGroup PAC ID 8123360088, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elders of Puerto Rico, PSC

  • Primary Care Clinic/Center
  • San Juan, PR
  • NPI 1225541949
  Medicare reassignment Care Compare group NPD Authorized official
• Servicios Psicologicos Vive, PSC.

  • Clinical Psychologist
  • San Juan, PR
  • NPI 1962796599
  NPD (past)

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310083200000",
    "number": "1194011452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 AVE DE DIEGO",
            "address_2": "CRYSTAL HOUSE APT 602",
            "city": "RIO PIEDRAS",
            "state": "PR",
            "postal_code": "009232916",
            "telephone_number": "787-530-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PMB 410 DE DIEGO AVE 89",
            "address_2": "SUITE 105",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00927",
            "telephone_number": "787-530-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABALLERO-GIPPSON",
        "first_name": "EDESTHER",
        "middle_name": "ALEJANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2011-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CABALLERO",
            "last_name": "GIPPSON",
            "prefix": "DR.",
            "credential": "P.H. D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• C.a.Ba Therapy LLC
• C&C Professional Therapy Group
• C&M Medical Services, P.S.C
• C&S Ambulances Services Inc.
• Pamela Caballero Maldonado
• Carmen Caballero, M.D.
• Fabiola Mari Caban Bravo
• Jelanie Marie Caban Rivera
• Erik Omar Caban Rodriguez, M.D.
• Michelle Angeli Caban Ruiz, PH.D.

• Clinical Psychologist in San Juan, PR
• Providers in San Juan, PR by specialty
• Clinical Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.