Nickole J Berrios-Santiago

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4076 Issued in PR

Practice address

506 Coto Laurel, Carr. Marginal
Legacy Office Park Suite 102
Ponce, PR 00780-9998

Phone

(787) 813-2222

NPI assigned

Feb 25, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1205228459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CALLE AMAPA",
            "address_2": "URB. VISTA ALEGRE",
            "city": "VILLALBA",
            "state": "PR",
            "postal_code": "007662905",
            "telephone_number": "787-517-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 COTO LAUREL, CARR. MARGINAL",
            "address_2": "LEGACY OFFICE PARK SUITE 102",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007809998",
            "telephone_number": "787-813-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRIOS-SANTIAGO",
        "first_name": "NICKOLE",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-25",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "PR",
            "license": "4076",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "4076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marielle Bernard
• Daniela Del Carmen Bernardo Silva, MSC
• Claudio P Bernaschina Bobadilla, MD, FACS
• Luis Bernier Rivera
• Rochelle Medina Berrios Medina, LCSW
• Carolina Berrios
• Gilmarie Berrios, DR
• Karen Berrios, M.D.
• Karla Marie Berrios, MSW
• Raquel Berrios, LND

• Clinical Psychologist in Ponce, PR
• Providers in Ponce, 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 Mar 7, 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.

Verify at the official NPI Registry.