Active NPI
Rene Javier Perez Pacheco
- Psychologist
- Ponce, PR
National Provider Identifier
1447023635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 7730
- Practice address
- 3218 Ave Emilio Fagot
Ponce, PR 00730-4603 - Phone
- (787) 233-3786
- NPI assigned
- Oct 31, 2023
- Last updated
- May 28, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 7730 | PR | Primary |
Addresses
Primary practice location
3218 Ave Emilio Fagot
Ponce, PR 00730-4603
Mailing address
3218 Ave Emilio Fagot
Ponce, PR 00730-4603
Phone (787) 233-3786
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7730 | PR | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716854400000",
"number": "1447023635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3218 AVE EMILIO FAGOT",
"city": "PONCE",
"state": "PR",
"postal_code": "007304603",
"telephone_number": "787-233-3786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3218 AVE EMILIO FAGOT",
"city": "PONCE",
"state": "PR",
"postal_code": "007304603",
"telephone_number": "787-233-3786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ PACHECO",
"first_name": "RENE",
"middle_name": "JAVIER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-10-31",
"last_updated": "2024-05-28",
"certification_date": "2024-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PR",
"license": "7730",
"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 May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.