Active NPI
Yesenia M Perez Roman, DRA
- Clinical Psychologist
- Aguadilla, PR
National Provider Identifier
1457891038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5706
- Practice address
- Jesus Tito Pineiro #3 Suite 203
Aguadilla, PR 00605 - Phone
- (787) 677-8920
- NPI assigned
- Mar 2, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5706 | PR | Primary |
Addresses
Primary practice location
Jesus Tito Pineiro #3 Suite 203
Aguadilla, PR 00605
Mailing address
HC 3 Box 33400
San Sebastian, PR 00685-7540
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241113001759 | PR | Practitioner - Psychologist Billing Independently | 2567996515 | Practice locations: Aguadille, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713312000000",
"number": "1457891038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 3 BOX 33400",
"city": "SAN SEBASTIAN",
"state": "PR",
"postal_code": "006857540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "JESUS TITO PINEIRO #3 SUITE 203",
"city": "AGUADILLA",
"state": "PR",
"postal_code": "00605",
"telephone_number": "787-677-8920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ ROMAN",
"first_name": "YESENIA",
"middle_name": "M",
"credential": "DRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-02",
"last_updated": "2024-04-17",
"certification_date": "2024-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "5706",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aguadilla, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.