Active NPI
Walkiria A De Jesus, P.D MS ED.
- School Psychologist
- Miami Gardens, FL
National Provider Identifier
1467795278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- Practice address
- 18425 NW 2ND Ave PH 5
Miami Gardens, FL 33169-4524 - Phone
- (954) 257-7473
- Fax
- (877) 578-5333
- NPI assigned
- Mar 29, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | SS-1507 | FL | |
| School Psychologist | 103TS0200X | Primary |
Addresses
Primary practice location
18425 NW 2ND Ave PH 5
Miami Gardens, FL 33169-4524
Mailing address
2635 Mead Ave
Saint Cloud, FL 34771-7875
Phone (917) 557-5575
Other practice location 1
1042B East 217 Street
B
Bronx, NY 10469
Phone (917) 557-5575
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SS-1507 | FL | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620950400000",
"number": "1467795278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2635 MEAD AVE",
"city": "SAINT CLOUD",
"state": "FL",
"postal_code": "347717875",
"telephone_number": "917-557-5575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18425 NW 2ND AVE PH 5",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "331694524",
"telephone_number": "954-257-7473",
"fax_number": "877-578-5333"
}
],
"practiceLocations": [
{
"address_1": "1042B East 217 Street",
"address_2": "B",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "10469",
"country_code": "US",
"telephone_number": "917-557-5575",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DE JESUS",
"first_name": "WALKIRIA",
"middle_name": "A",
"credential": "P.D MS ED.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-29",
"last_updated": "2021-05-14",
"certification_date": "2021-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "FL",
"license": "SS-1507",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Miami Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.