Active NPI
Jose Angel Gandia, PH.D.
- Clinical Psychologist
- Ponce, PR
National Provider Identifier
1235404070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3500
- Practice address
- 9140 Calle Marina
Suite 502
Ponce, PR 00717 - Phone
- (787) 485-6348
- NPI assigned
- Mar 13, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3500 | PR | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 3500 | PR | |
| Family Psychologist | 103TF0000X | 3500 | PR | |
| Group Psychotherapy Psychologist | 103TP2701X | 3500 | PR |
Addresses
Primary practice location
9140 Calle Marina
Suite 502
Ponce, PR 00717
Mailing address
9140 Calle Marina
Suite 502
Ponce, PR 00717
Phone (787) 485-6348
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3500 | PR | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psicsur | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Ponce, PR
- NPI 1528330362
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331596800000",
"number": "1235404070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9140 CALLE MARINA",
"address_2": "SUITE 502",
"city": "PONCE",
"state": "PR",
"postal_code": "00717",
"telephone_number": "787-485-6348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9140 CALLE MARINA",
"address_2": "SUITE 502",
"city": "PONCE",
"state": "PR",
"postal_code": "00717",
"telephone_number": "787-485-6348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANDIA",
"first_name": "JOSE",
"middle_name": "ANGEL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-03-13",
"last_updated": "2012-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "3500",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "PR",
"license": "3500",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "PR",
"license": "3500",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "PR",
"license": "3500",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponce, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.