Individual provider Active NPI

Irmarys Rosado Frau, CLINICAL PSYCHOLOGY

  • Clinical Psychologist
  • San Juan, PR
National Provider Identifier
1417668260
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7618 Issued in PR
Practice address
Edificio C C/ Maga Bo. Monacillos
Centro Medico
San Juan, PR 00928
Phone
(787) 763-7575
NPI assigned
Dec 12, 2022
Last updated
Dec 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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 7618 PR Primary

Addresses

Primary practice location

Edificio C C/ Maga Bo. Monacillos
Centro Medico
San Juan, PR 00928

Mailing address

PO Box 741
Rio Grande, PR 00745-0741
Phone (939) 277-9353

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7618PRMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1417668260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "007450741",
            "telephone_number": "939-277-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EDIFICIO C C/ MAGA BO. MONACILLOS",
            "address_2": "CENTRO MEDICO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00928",
            "telephone_number": "787-763-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSADO FRAU",
        "first_name": "IRMARYS",
        "name_prefix": "Dr.",
        "credential": "CLINICAL PSYCHOLOGY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "7618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.