Individual provider Active NPI

Coral del Mar Santiago, PSYD

  • Clinical Psychologist
  • San Juan, PR
National Provider Identifier
1205695574
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7751 Issued in PR
Practice address
1788 Calle Julio Aybar
San Juan, PR 00921-4410
Phone
(787) 326-0011
NPI assigned
Mar 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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 7751 PR Primary

Addresses

Primary practice location

1788 Calle Julio Aybar
San Juan, PR 00921-4410

Mailing address

1410 Calle Luisa Capetillo
Urb. Santiago Iglesias
San Juan, PR 00921-4124
Phone (787) 299-5651

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
I20260220002239 PR Practitioner - Clinical Psychologist 2062993785 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1410 Calle Luisa Capetillo
San Juan, PR 00921

1788 Calle Julio Aybar
San Juan, PR 00921-4410
Phone (787) 326-0011

PO Box
Suite 1052
Gurabo, PR 00778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7751PRMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1205695574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 CALLE LUISA CAPETILLO",
            "address_2": "URB. SANTIAGO IGLESIAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009214124",
            "telephone_number": "787-299-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1788 CALLE JULIO AYBAR",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009214410",
            "telephone_number": "787-326-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "CORAL DEL MAR",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "7751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.