Active NPI
Alexa Milagros Jimenez, PSYD
- Clinical Psychologist
- San Juan, PR
National Provider Identifier
1467654111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY8512
- Practice address
- 10 Calle Casia
US Dept of Vererans Affairs Carribean Healthcare System
San Juan, PR 00921 - Phone
- (787) 641-7582
- NPI assigned
- Jun 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY8512 | FL | Primary |
| Clinical Psychologist | 103TC0700X | 3888 | PR |
Addresses
Primary practice location
10 Calle Casia
US Dept of Vererans Affairs Carribean Healthcare System
San Juan, PR 00921
Mailing address
6514 Calle San Edmundo
Urbanizacion Santa Teresita
Ponce, PR 00730
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY8512 | FL | MD | Clinical Psychologist |
| 3888 | PR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491868800000",
"number": "1467654111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6514 CALLE SAN EDMUNDO",
"address_2": "URBANIZACION SANTA TERESITA",
"city": "PONCE",
"state": "PR",
"postal_code": "00730",
"telephone_number": "787-641-7582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 CALLE CASIA",
"address_2": "US DEPT OF VERERANS AFFAIRS CARRIBEAN HEALTHCARE SYSTEM",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00921",
"telephone_number": "787-641-7582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "ALEXA",
"middle_name": "MILAGROS",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-04",
"last_updated": "2017-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY8512",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "3888",
"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 Apr 11, 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.