Active NPI
Angelica Marie Bonilla Tanon, PSYD
- Counseling Psychologist
- Toa Baja, PR
National Provider Identifier
1306554639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 6330
- Practice address
- 2514 Paseo Amparo
Toa Baja, PR 00949-4323 - Phone
- (939) 200-5353
- NPI assigned
- Nov 7, 2022
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 6330 | PR | Primary |
Addresses
Primary practice location
2514 Paseo Amparo
Toa Baja, PR 00949-4323
Mailing address
2514 Paseo Amparo
Toa Baja, PR 00949-4323
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250319004190 | PR | Practitioner - Psychologist Billing Independently | 7416479357 | Practice locations: Toa Baja, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6330 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744502400000",
"number": "1306554639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2514 PASEO AMPARO",
"city": "TOA BAJA",
"state": "PR",
"postal_code": "009494323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2514 PASEO AMPARO",
"city": "TOA BAJA",
"state": "PR",
"postal_code": "009494323",
"telephone_number": "939-200-5353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONILLA TANON",
"first_name": "ANGELICA",
"middle_name": "MARIE",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-07",
"last_updated": "2025-04-13",
"certification_date": "2025-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "PR",
"license": "6330",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toa Baja, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.