Individual provider Active NPI

Josephine De Los Santos, PH.D.

  • Psychologist
  • Mission, TX
National Provider Identifier
1336225416
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
32555 Issued in TX
Practice address
2504 N Conway Ave
Mission, TX 78574-2349
Phone
(956) 519-9000
Fax
(956) 519-7722
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 32555 TX Primary

Addresses

Primary practice location

2504 N Conway Ave
Mission, TX 78574-2349

Mailing address

2504 N Conway Ave
Mission, TX 78574-2349
Phone (956) 519-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050328000277 TX Practitioner - Clinical Psychologist 6507812112 Practice locations: Mission, TX

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32555TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Psychological Center, P.a. PastSince Apr 1, 1998 Accepting new patients
Deer Oaks Geriatric Services P C PastSince Jan 23, 2023 Accepting new patients

Organizations & group practices 2

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1336225416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 N CONWAY AVE",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785742349",
            "telephone_number": "956-519-9000",
            "fax_number": "956-519-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 N CONWAY AVE",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785742349",
            "telephone_number": "956-519-9000",
            "fax_number": "956-519-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LOS SANTOS",
        "first_name": "JOSEPHINE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "32555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

Verify at the official NPI Registry.