Individual provider Active NPI

Gabrielle A. Ruiz-Tudo, M.A.

  • Psychologist
  • San Juan, PR
National Provider Identifier
1487082947
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3814 Issued in PR
Practice address
1666 Calle Parana
San Juan, PR 00926-3145
Phone
(787) 941-1010
NPI assigned
Oct 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3814 PR Primary
School Psychologist 103TS0200X 3814 PR

Addresses

Primary practice location

1666 Calle Parana
San Juan, PR 00926-3145

Mailing address

109 Calle Costa Rica
Apt. 12-a
San Juan, PR 00917-2417
Phone (832) 775-5444

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 Arts

State licenses

LicenseStateTypeSpecialty
3814PRMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1382313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1487082947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CALLE COSTA RICA",
            "address_2": "APT. 12-A",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009172417",
            "telephone_number": "832-775-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 CALLE PARANA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009263145",
            "telephone_number": "787-941-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ-TUDO",
        "first_name": "GABRIELLE",
        "middle_name": "A.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-21",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "3814",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "PR",
            "license": "3814",
            "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 Nov 6, 2013; 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.