Individual provider Active NPI

Jacqueline Castillo

  • Speech-Language Assistant
  • Aguada, PR
National Provider Identifier
1396528972
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
7740 Issued in PR
Practice address
Carr 417 KM 2.3 Bo. Malpaso
Aguada, PR 00602
Phone
(939) 235-0543
NPI assigned
Aug 16, 2023
Last updated
Aug 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 7740 PR Primary

Addresses

Primary practice location

Carr 417 KM 2.3 Bo. Malpaso
Aguada, PR 00602

Mailing address

HC 3 Box 6565
Rincon, PR 00677-9090
Phone (787) 902-0330

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
7740PRMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1396528972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 3 BOX 6565",
            "city": "RINCON",
            "state": "PR",
            "postal_code": "006779090",
            "telephone_number": "787-902-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 417 KM 2.3 BO. MALPASO",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "00602",
            "telephone_number": "939-235-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "PR",
            "license": "7740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aguada, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.