Active NPI
Carmen B Caraballo Rodriguez
- Clinical Psychologist
- Ponce, PR
National Provider Identifier
1245938018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 7505
- Practice address
- 2961 Ave. Roosevelt a-1
Urb. Mariani
Ponce, PR 00717 - Phone
- (787) 438-3117
- NPI assigned
- Feb 21, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 7505 | PR | Primary |
Addresses
Primary practice location
2961 Ave. Roosevelt a-1
Urb. Mariani
Ponce, PR 00717
Mailing address
J2 Calle Sandalo
Jardines Fagot
Ponce, PR 00716
Phone (787) 616-1714
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676937600000",
"number": "1245938018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "J2 CALLE SANDALO",
"address_2": "JARDINES FAGOT",
"city": "PONCE",
"state": "PR",
"postal_code": "00716",
"telephone_number": "787-616-1714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2961 AVE. ROOSEVELT A-1",
"address_2": "URB. MARIANI",
"city": "PONCE",
"state": "PR",
"postal_code": "00717",
"telephone_number": "787-438-3117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARABALLO RODRIGUEZ",
"first_name": "CARMEN",
"middle_name": "B",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-21",
"last_updated": "2023-02-21",
"certification_date": "2023-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "7505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponce, PR
- Lupita Lyn Caquias
- Yeidi D Caraballo Maldonado, PHL
- Glenda Caraballo Ortiz
- Emmanuelle Jose Caraballo Rivera, M.SC.
- Valery Marie Caraballo Rivera, PA
- Ariana Carolina Caraballo Soler
- Johnathan Alexander Caraballo Solis, MD
- Nilsa Caraballo Torres, PHARMACY TECHNICIAN
- Daniel Caraballo-Burgos, OD
- Delmarie Caraballo, BSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.