Individual provider Active NPI

Waleska Ruiz, PSY.D

  • Clinical Psychologist
  • Quebradillas, PR
National Provider Identifier
1376983353
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6901 Issued in PR
Practice address
Barrio Cacao
Carretera 4474 KM. 0.1
Quebradillas, PR 00678
Phone
(787) 895-8080
Fax
(939) 666-0390
NPI assigned
Jul 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11682 PR
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 6901 PR Primary

Addresses

Primary practice location

Barrio Cacao
Carretera 4474 KM. 0.1
Quebradillas, PR 00678

Mailing address

PO Box 1366
Isabela, PR 00662-1366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130827000648 PR Practitioner - Clinical Social Worker 3173766912 Practice locations: Quebradillas, PR
I20210409001060 PR Practitioner - Clinical Psychologist 3173766912 Practice locations: Quebradillas, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6901PRMDClinical Psychologist
11682PRMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
San Antonio Medical LLC PastSince Apr 9, 2023 Accepting new patients
Excelence Healthcare, C.S.P. PastSince Apr 16, 2023 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1376983353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1366",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "006621366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BARRIO CACAO",
            "address_2": "CARRETERA 4474 KM. 0.1",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "00678",
            "telephone_number": "787-895-8080",
            "fax_number": "939-666-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "WALESKA",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-05",
        "last_updated": "2023-04-05",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PR",
            "license": "11682",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "6901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quebradillas, PR

Sources for this page

Verify at the official NPI Registry.