Individual provider Active NPI

Bethzaida Orengo, DOCTORATE IN CLINICA

  • Clinical Psychologist
  • Ponce, PR
National Provider Identifier
1255605168
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2573 Issued in PR
Practice address
Fagot Avenue #3260
Ponce, PR 00730
Phone
(787) 385-9752
Fax
(787) 841-6747
NPI assigned
Feb 24, 2012
Last updated
Feb 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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 2573 PR Primary

Addresses

Primary practice location

Fagot Avenue #3260
Ponce, PR 00730

Mailing address

P.O. Box 560673
Guayanilla, PR 00656
Phone (787) 835-5394

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
2573PRMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Abro Inc. CurrentSince May 20, 2012 Accepting new patients

Locations

3260 Ave Emilio Fagot
Ponce, PR 00730
Phone (787) 651-7952

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1255605168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 560673",
            "city": "GUAYANILLA",
            "state": "PR",
            "postal_code": "00656",
            "telephone_number": "787-835-5394",
            "fax_number": "787-841-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FAGOT AVENUE #3260",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00730",
            "telephone_number": "787-385-9752",
            "fax_number": "787-841-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORENGO",
        "first_name": "BETHZAIDA",
        "name_prefix": "Mrs.",
        "credential": "DOCTORATE IN CLINICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-24",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "2573",
            "primary": true
        }
    ],
    "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 Feb 20, 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.