Active NPI
Carmen Soto, PHD
- Clinical Psychologist
- San Juan, PR
National Provider Identifier
1487797007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2369
- Practice address
- 200 Ave Cupey GDNS
Plaza Cupey Gardens, Sector #3
San Juan, PR 00926-7341 - Phone
- (787) 292-0205
- Fax
- (787) 292-0205
- NPI assigned
- Feb 14, 2007
- 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 | 2369 | PR | Primary |
Addresses
Primary practice location
200 Ave Cupey GDNS
Plaza Cupey Gardens, Sector #3
San Juan, PR 00926-7341
Mailing address
HC 645 Box 6387
Trujillo Alto, PR 00976-9746
Phone (787) 292-0205
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04553 | Other | PR | PSYCHOLOGIST |
| A861 | Other | PR | PSYCHOLOGIST |
| 1739 | Other | PR | PSHYCHOLOGIST |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2369 | PR | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Servicios Psicoligicos Raigambre | Clinical | Past | Accepting new patients |
| Servicios Psicologicos Raigambre | 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.
-
- Clinical Psychologist
- San Juan, PR
- NPI 1003922865
-
- Psychologist
- San Juan, PR
- NPI 1245245091
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487797007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 645 BOX 6387",
"city": "TRUJILLO ALTO",
"state": "PR",
"postal_code": "009769746",
"telephone_number": "787-292-0205",
"fax_number": "787-292-0205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 AVE CUPEY GDNS",
"address_2": "PLAZA CUPEY GARDENS, SECTOR #3",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009267341",
"telephone_number": "787-292-0205",
"fax_number": "787-292-0205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTO",
"first_name": "CARMEN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "2369",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGIST",
"identifier": "04553",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGIST",
"identifier": "A861",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSHYCHOLOGIST",
"identifier": "1739",
"state": "PR"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.