Individual provider Active NPI

Laura M Deliz, PSYD

  • Clinical Psychologist
  • Ponce, PR
National Provider Identifier
1376781211
Registry record updated Jan 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3095 Issued in PR
Practice address
Centro Ponceno de Autismo
Calle Sol 120
Ponce, PR 00730-2267
Phone
(787) 812-1224
NPI assigned
Jan 30, 2009
Last updated
Jan 30, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2009

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 3095 PR Primary

Addresses

Primary practice location

Centro Ponceno de Autismo
Calle Sol 120
Ponce, PR 00730-2267

Mailing address

PO Box 32267
Ponce, PR 00732-2267
Phone (787) 812-1224

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

State licenses

LicenseStateTypeSpecialty
3095PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Ponceno de Autismo Current Accepting new patients

Locations

120 Calle Sol
Ponce, PR 00730
Phone (787) 284-2900

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": "1233273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233273600000",
    "number": "1376781211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32267",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007322267",
            "telephone_number": "787-812-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CENTRO PONCENO DE AUTISMO",
            "address_2": "CALLE SOL 120",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007302267",
            "telephone_number": "787-812-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELIZ",
        "first_name": "LAURA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-30",
        "last_updated": "2009-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; 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.