Individual provider Active NPI

John Martin Velasquez, PH.D., LP

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1508317116
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
30898 Issued in TX
Practice address
4030 Tallulah Dr
San Antonio, TX 78218-3448
Phone
(210) 241-4180
NPI assigned
Oct 18, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 30898 TX Primary

Addresses

Primary practice location

4030 Tallulah Dr
San Antonio, TX 78218-3448

Mailing address

4030 Tallulah Dr
San Antonio, TX 78218-3448
Phone (210) 241-4180

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
30898TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Vcounselors PLLC PastSince May 16, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: john.velasquez.1@30520.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1508317116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 TALLULAH DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782183448",
            "telephone_number": "210-241-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 TALLULAH DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782183448",
            "telephone_number": "210-241-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "JOHN",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "PH.D., LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-18",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "30898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; 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.