Active NPI
Wanda L Decardona, PSYD
- Clinical Psychologist
- San Juan, PR
National Provider Identifier
1508166554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1992
- Practice address
- Cond City View Tower Apt 203, Violetas St 2002
San Juan, PR 00915 - Phone
- (787) 646-0311
- NPI assigned
- Oct 25, 2010
- 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 | 1992 | PR | Primary |
Addresses
Primary practice location
Cond City View Tower Apt 203, Violetas St 2002
San Juan, PR 00915
Mailing address
Cond City View Tower Apt 203, Violetas St 2002
San Juan, PR 00915
Phone (787) 646-0311
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 |
|---|---|---|---|
| 1992 | PR | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287964800000",
"number": "1508166554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "COND CITY VIEW TOWER APT 203, VIOLETAS ST 2002",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00915",
"telephone_number": "787-646-0311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "COND CITY VIEW TOWER APT 203, VIOLETAS ST 2002",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00915",
"telephone_number": "787-646-0311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECARDONA",
"first_name": "WANDA",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-25",
"last_updated": "2010-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "1992",
"primary": true
}
],
"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 Oct 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.