Individual provider Active NPI

Liza Yvette Maldonado, PSY.D.

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1215248422
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
34662 Issued in TX
Practice address
8627 Cinnamon Creek Dr
Ste 601
San Antonio, TX 78240-1482
Phone
(210) 780-8692
NPI assigned
Jun 23, 2010
Last updated
Jul 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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 34662 TX Primary

Addresses

Primary practice location

8627 Cinnamon Creek Dr
Ste 601
San Antonio, TX 78240-1482

Mailing address

3418 Huntwick LN
San Antonio, TX 78230-3958
Phone (210) 254-0821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130411000140 TX Practitioner - Clinical Psychologist 4486890795 Practice locations: San Antonio, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8627 Cinnamon Creek Dr
Suite 601
San Antonio, TX 78240-1482
Phone (210) 780-8692

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Consultants Past Accepting new patients
Vcounselors PLLC PastSince May 16, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1215248422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3418 HUNTWICK LN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782303958",
            "telephone_number": "210-254-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8627 CINNAMON CREEK DR",
            "address_2": "STE 601",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401482",
            "telephone_number": "210-780-8692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "LIZA",
        "middle_name": "YVETTE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "34662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.