Ilia M Apellaniz Barreto, ED.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0029 Issued in PR

Practice address

1574 Calle Bori
Urb. Caribe
San Juan, PR 00927-6113

Phone

(787) 765-3411

NPI assigned

Mar 10, 2008

Last updated

Jan 3, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1336319011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 AVE HOSTOS",
            "address_2": "URBANIZACION BALDRICH",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009184038",
            "telephone_number": "787-765-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1574 CALLE BORI",
            "address_2": "URB. CARIBE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009276113",
            "telephone_number": "787-765-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APELLANIZ BARRETO",
        "first_name": "ILIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-10",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "0029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39877500",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in San Juan, PR
• Providers in San Juan, PR by specialty
• Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; 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.