Active NPI
Ydsia J Rivera Vazquez, PSYD
- Clinical Psychologist
- San Juan, PR
National Provider Identifier
1225259591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2139
- Practice address
- Avenida Americo Miranda 1422
Urb Caparra Terrace
San Juan, PR 00921 - Phone
- (787) 783-8738
- NPI assigned
- May 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2139 | PR | Primary |
Addresses
Primary practice location
Avenida Americo Miranda 1422
Urb Caparra Terrace
San Juan, PR 00921
Mailing address
100 Calle 5
Apt C 11 Universal Plaza
Trujillo Alto, PR 00976
Phone (787) 783-8738
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 219168 | Other | PR | PREFERRED HEALTH |
| A644 | Other | PR | FIRST MEDICAL |
| 3185 | Other | PR | APS |
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 |
|---|---|---|---|
| 2139 | PR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225259591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 CALLE 5",
"address_2": "APT C 11 UNIVERSAL PLAZA",
"city": "TRUJILLO ALTO",
"state": "PR",
"postal_code": "00976",
"telephone_number": "787-783-8738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "AVENIDA AMERICO MIRANDA 1422",
"address_2": "URB CAPARRA TERRACE",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00921",
"telephone_number": "787-783-8738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA VAZQUEZ",
"first_name": "YDSIA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "2139",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED HEALTH",
"identifier": "219168",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST MEDICAL",
"identifier": "A644",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APS",
"identifier": "3185",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.