Individual provider Active NPI

Jenny Rodriguez-Jimenez, PH.D., M.S.W.

  • Clinical Psychologist
  • Carolina, PR
National Provider Identifier
1255300026
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
001453 Issued in PR
Practice address
6471 Ave Isla Verde
Local 4 New San Juan Commercial
Carolina, PR 00979-7103
Phone
(787) 564-4839
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 001453 PR Primary

Addresses

Primary practice location

6471 Ave Isla Verde
Local 4 New San Juan Commercial
Carolina, PR 00979-7103

Mailing address

D10 Calle Temple
Urb Santa Ana
San Juan, PR 00927-4904
Phone (787) 564-4839

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
001453PRMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1255300026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "D10 CALLE TEMPLE",
            "address_2": "URB SANTA ANA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009274904",
            "telephone_number": "787-564-4839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6471 AVE ISLA VERDE",
            "address_2": "LOCAL 4 NEW SAN JUAN COMMERCIAL",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009797103",
            "telephone_number": "787-564-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-JIMENEZ",
        "first_name": "JENNY",
        "name_prefix": "Dr.",
        "credential": "PH.D., M.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "001453",
            "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 Sep 17, 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.

Verify at the official NPI Registry.