Individual provider Active NPI

Maritere Quintana Cruz, PH.D PSY.

  • Clinical Psychologist
  • Lares, PR
National Provider Identifier
1326774019
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7415 Issued in PR
Practice address
Ave. Los Patriotas KM 1.8
Lares, PR 00669
Phone
(787) 318-1195
NPI assigned
Jul 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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 7415 PR Primary

Addresses

Primary practice location

Ave. Los Patriotas KM 1.8
Lares, PR 00669

Mailing address

PO Box 177
Castaner, PR 00631-0177

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
I20230125000122 PR Practitioner - Clinical Psychologist 8628449063 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
7415PRMDSurgical Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Servicios de Salud Primarios de Barceloneta, Inc. CurrentSince Sep 17, 2022 Accepting new patients
Servicios de Salud Primarios de Barceloneta, Inc. Current Accepting new patients
Servicios de Salud Primarios de Barceloneta, Inc. CurrentSince Sep 17, 2022 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1326774019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 177",
            "city": "CASTANER",
            "state": "PR",
            "postal_code": "006310177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. LOS PATRIOTAS KM 1.8",
            "city": "LARES",
            "state": "PR",
            "postal_code": "00669",
            "telephone_number": "787-318-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANA CRUZ",
        "first_name": "MARITERE",
        "credential": "PH.D PSY.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "7415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lares, PR

Sources for this page

Verify at the official NPI Registry.