Individual provider Active NPI

Ivonne Sanabria Burgos, PSY D

  • Clinical Psychologist
  • Bayamon, PR
National Provider Identifier
1316045024
Registry record updated Oct 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2301 Issued in PR
Practice address
Cond Casa Linda
Apt 107
Bayamon, PR 00959-8999
Phone
(787) 297-2917
NPI assigned
Sep 20, 2006
Last updated
Oct 21, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2008

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 2301 PR Primary

Addresses

Primary practice location

Cond Casa Linda
Apt 107
Bayamon, PR 00959-8999

Mailing address

Casa Linda Village
Apt 107
Bayamon, PR 00959-0000
Phone (787) 297-2917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161003001219 PR Practitioner - Clinical Psychologist 0648567800 Practice locations: Carolina, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aps Clinics of Puerto Rico, Inc. Past Accepting new patients

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1316045024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CASA LINDA VILLAGE",
            "address_2": "APT 107",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009590000",
            "telephone_number": "787-297-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COND CASA LINDA",
            "address_2": "APT 107",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009598999",
            "telephone_number": "787-297-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANABRIA BURGOS",
        "first_name": "IVONNE",
        "credential": "PSY D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "2301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.