Individual provider Active NPI

Idania Liz Arroyo Perez, PH.D.

  • Clinical Psychologist
  • Aguadilla, PR
National Provider Identifier
1356633002
Registry record updated Jun 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3848 Issued in PR
Practice address
2045 Ave Pedro Albizu Campos Ste 2
Aguadilla, PR 00603
Phone
(939) 339-1402
NPI assigned
May 12, 2011
Last updated
Jun 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2018

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 3848 PR Primary

Addresses

Primary practice location

2045 Ave Pedro Albizu Campos Ste 2
Aguadilla, PR 00603

Mailing address

RR 1 Box 1101
Anasco, PR 00610-9750
Phone (787) 510-0033

Other practice location 1

RR 1 Box 1101
Anasco, PR 00610-9750
Phone (787) 510-0033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190503000149 PR Practitioner - Psychologist Billing Independently 8426390949 Reassigns benefits to 1 organization
Practice locations: Aguadilla, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3848PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica de Servicios Psicologicos Y del Desarrollo, C.S.P. Psychologist CurrentSince Jun 9, 2019 Accepting new patients

Locations

2045 Ave Pedro Albizu Campos
Ste 2
Aguadilla, PR 00603
Phone (787) 510-0033

Organizations & group practices 1

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": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528502400000",
    "number": "1356633002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 1101",
            "city": "ANASCO",
            "state": "PR",
            "postal_code": "006109750",
            "telephone_number": "787-510-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 AVE PEDRO ALBIZU CAMPOS STE 2",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "00603",
            "telephone_number": "939-339-1402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "RR 1 Box 1101",
            "address_purpose": "LOCATION",
            "city": "Anasco",
            "state": "PR",
            "postal_code": "006109750",
            "country_code": "US",
            "telephone_number": "787-510-0033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARROYO PEREZ",
        "first_name": "IDANIA",
        "middle_name": "LIZ",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-12",
        "last_updated": "2018-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguadilla, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.