Active NPI
Mariely Rivera-Carrasquillo, PH.D.
- Psychiatric Hospital
- Gurabo, PR
National Provider Identifier
1366735615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital
- License
- 3932
- Practice address
- Camino Los Ucares 458
Sabanera del Rio
Gurabo, PR 00778-0077 - Phone
- (787) 745-1196
- NPI assigned
- May 19, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3932 | PR | |
| Psychiatric Hospital | 283Q00000X | 3932 | PR | Primary |
Addresses
Primary practice location
Camino Los Ucares 458
Sabanera del Rio
Gurabo, PR 00778-0077
Mailing address
# 458 Camino Los Ucares
Sabanera del Rio
Gurabo, PR 00778
Phone (787) 745-1196
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3932 | PR | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305763200000",
"number": "1366735615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "# 458 CAMINO LOS UCARES",
"address_2": "SABANERA DEL RIO",
"city": "GURABO",
"state": "PR",
"postal_code": "00778",
"telephone_number": "787-745-1196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CAMINO LOS UCARES 458",
"address_2": "SABANERA DEL RIO",
"city": "GURABO",
"state": "PR",
"postal_code": "007780077",
"telephone_number": "787-745-1196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA-CARRASQUILLO",
"first_name": "MARIELY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-19",
"last_updated": "2011-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "3932",
"primary": false
},
{
"code": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": "PR",
"license": "3932",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gurabo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.