Active NPI
Myrna Santiago, PSY.D.
- Clinical Psychologist
- Carolina, PR
National Provider Identifier
1225213374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1869
- Practice address
- Centro Comercial Plaza 66
Suite 5C
Carolina, PR 00987 - Phone
- (787) 594-7328
- NPI assigned
- Jan 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3033 | PR | |
| Clinical Psychologist | 103TC0700X | 1869 | PR | Primary |
Addresses
Primary practice location
Centro Comercial Plaza 66
Suite 5C
Carolina, PR 00987
Mailing address
PO Box 6022
PMB 100
Carolina, PR 00988-6022
Phone (787) 594-7328
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1869 | PR | MD | Physical Therapy Assistant |
| 3033 | PR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451520000000",
"number": "1225213374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6022",
"address_2": "PMB 100",
"city": "CAROLINA",
"state": "PR",
"postal_code": "009886022",
"telephone_number": "787-594-7328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CENTRO COMERCIAL PLAZA 66",
"address_2": "SUITE 5C",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00987",
"telephone_number": "787-594-7328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO",
"first_name": "MYRNA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-08",
"last_updated": "2015-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PR",
"license": "3033",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "1869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carolina, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.