Organization Active NPI

Clinica de Servicios Psicologicos Despertar LLC

  • Health Psychologist
  • Fajardo, PR
National Provider Identifier
1205565660
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health PsychologistTaxonomy code 103TH0004X
Legal business name
CLINICA DE SERVICIOS PSICOLOGICOS DESPERTAR LLC
Practice address
Torre Medica San Pablo Piso 5
Suite 504
Fajardo, PR 00738-3998
Phone
(787) 639-8894
NPI assigned
Jun 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Authorized official

Name
Karen Z Quinones Sanchez, MSNPI 1699243972
Title
Psychologist
Phone
(787) 528-8175

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TH0004X Primary

Addresses

Primary practice location

Torre Medica San Pablo Piso 5
Suite 504
Fajardo, PR 00738-3998

Mailing address

20 Ave Luis Munoz Marin PMB 349
Caguas, PR 00725-1956
Phone (787) 639-8894

National Provider Directory

National Provider Directory

Locations

20 Ave Luis Munoz Marin
Caguas, PR 00725

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1205565660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 AVE LUIS MUNOZ MARIN PMB 349",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007251956",
            "telephone_number": "787-639-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TORRE MEDICA SAN PABLO PISO 5",
            "address_2": "SUITE 504",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007383998",
            "telephone_number": "787-639-8894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA DE SERVICIOS PSICOLOGICOS DESPERTAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-05",
        "status": "A",
        "authorized_official_last_name": "QUINONES SANCHEZ",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "787-528-8175",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fajardo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.