Active NPI
Ileana Pagan, PSY.D.
- Clinical Psychologist
- Yauco, PR
National Provider Identifier
1356375455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1633
- Practice address
- Calle 25 de Julio Prolongacion #3
Yauco, PR 00698 - Phone
- (787) 396-4502
- Fax
- (787) 267-2989
- NPI assigned
- Jul 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1633 | PR | Primary |
Addresses
Primary practice location
Calle 25 de Julio Prolongacion #3
Yauco, PR 00698
Mailing address
521 Calle Madrid
Yauco, PR 00698-2566
Phone (787) 856-4133
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1633 | PR | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1356375455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "521 CALLE MADRID",
"city": "YAUCO",
"state": "PR",
"postal_code": "006982566",
"telephone_number": "787-856-4133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CALLE 25 DE JULIO PROLONGACION #3",
"city": "YAUCO",
"state": "PR",
"postal_code": "00698",
"telephone_number": "787-396-4502",
"fax_number": "787-267-2989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGAN",
"first_name": "ILEANA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "1633",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yauco, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.