Servicios Psicologicos Raigambre

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1330 Issued in PR

Legal business name

SERVICIOS PSICOLOGICOS RAIGAMBRE

Practice address

Plaza Cupey Gardens Sector 3
Urb Cupey Gardens
San Juan, PR 00936

Phone

(787) 292-0205

Fax

(787) 292-0205

NPI assigned

Jul 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marilyn Rodriguez, M.S.NPI 1609917897

Title

Administrator

Phone

(787) 292-0205

Specialties & licenses 1

Addresses

Other identifiers 9

Tax ID family

Servicios Psicologicos Raigambre2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Servicios Psicoligicos Raigambre

  • Clinical Psychologist
  • San Juan, PR
  • NPI 1003922865
  NPD tax ID

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marilyn Rodriguez, M.S.

  • Psychologist
  • San Juan, PR
  • NPI 1609917897
  NPD (past) Authorized official
• Jonathan Echevarria, PSY.D.

  • Clinical Psychologist
  • San Juan, PR
  • NPI 1912419284
  NPD (past)
• Javier A. Piazza, PSY.D.

  • Psychologist
  • San Juan, PR
  • NPI 1942352513
  NPD (past)
• Carmen Soto, PHD

  • Clinical Psychologist
  • San Juan, PR
  • NPI 1487797007
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245245091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 645 BOX 6387",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009769746",
            "telephone_number": "787-292-0205",
            "fax_number": "787-292-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PLAZA CUPEY GARDENS SECTOR 3",
            "address_2": "URB CUPEY GARDENS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00936",
            "telephone_number": "787-292-0205",
            "fax_number": "787-292-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERVICIOS PSICOLOGICOS RAIGAMBRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-292-0205",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "PR",
            "license": "1330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYC.",
            "identifier": "2403",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYC.",
            "identifier": "1739",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYC.",
            "identifier": "2246",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYC.",
            "identifier": "A861",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYC.",
            "identifier": "503628",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSIC.",
            "identifier": "A842",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSIC.",
            "identifier": "075148",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYC.",
            "identifier": "1713",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST",
            "identifier": "758",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Servicios Neonatales del Este CSP
• Servicios Patologicos de Manati
• Servicios Psicoligicos Raigambre
• Servicios Psicologicos Integrales
• Servicios Psicologicos LLC
• Servicios Psicologicos Vive, PSC.
• Servicios Psiquiatricos Dr. Ricardo Diez Delgado, CSP
• Servicios Radiologicos Asociados Jorge Perez Brais
• Servicios Urologicos de Puerto Rico
• Servicios Urologicos Inc

• Psychologist in San Juan, PR
• Providers in San Juan, PR by specialty
• Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.