Individual provider Active NPI

Mabel E. Quinones Vazquez, PHD

  • Clinical Psychologist
  • San Juan, PR
National Provider Identifier
1457374001
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3340 Issued in PR
Practice address
10 Casia St
Veterans Administration Medical Center
San Juan, PR 00921-3201
Phone
(787) 641-7582
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 013115 NY
Psychologist 103T00000X 3340 PR
Clinical Psychologist 103TC0700X 3340 PR Primary
Clinical Psychologist 103TC0700X 013115-1 NY

Addresses

Primary practice location

10 Casia St
Veterans Administration Medical Center
San Juan, PR 00921-3201

Mailing address

10 Casia St
Veterans Administration Medical Center
San Juan, PR 00921-3201
Phone (787) 641-7582

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
013115-1NYMDClinical Psychologist
013115NYMDChiropractor
3340PRMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Medical Center Past Accepting new patients
Beth Israel Medical Center Psychiatry & Behavioral Science Past 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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1457374001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CASIA ST",
            "address_2": "VETERANS ADMINISTRATION MEDICAL CENTER",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009213201",
            "telephone_number": "787-641-7582",
            "fax_number": "787-641-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CASIA ST",
            "address_2": "VETERANS ADMINISTRATION MEDICAL CENTER",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009213201",
            "telephone_number": "787-641-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINONES VAZQUEZ",
        "first_name": "MABEL",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "013115",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "3340",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3340",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013115-1",
            "primary": false
        }
    ],
    "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 Mar 1, 2017; 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.