Wanda I. Izquierdo Valle

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2067 Issued in PR

Practice address

226 Costa Norte Estrella de Mar
226
Hatillo, PR 00659-0065

Phone

(787) 310-5821

NPI assigned

Aug 11, 2022

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1346978962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 CALLE ESTRELLA DE MAR # 226",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006592747",
            "telephone_number": "787-310-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 COSTA NORTE ESTRELLA DE MAR",
            "address_2": "226",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006590065",
            "telephone_number": "787-310-5821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZQUIERDO VALLE",
        "first_name": "WANDA",
        "middle_name": "I.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "2067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Innovare Dental
• Instituto de Fisioterapia Activa
• Instituto Psicologico Y Educativo del Norte
• Yolanda Irizarry
• Hannia Izagas
• Jeannette Toledo Rodriguez
• Natalia Zayrah Jimenez Colon, MD
• Joyce Nicole Jimenez Rodriguez, SLP
• Obet Jimenez- Ortega, M.D.
• Jaimairis Jimenez

• Clinical Psychologist in Hatillo, PR
• Providers in Hatillo, PR by specialty
• Clinical Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.