Individual provider Active NPI

Keyla Nicole Vega Vicente, OTA/L

  • Occupational Therapy Assistant
  • San Juan, PR
National Provider Identifier
1528748142
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
1492 Issued in PR
Practice address
00921 PR-21, San Juan, 00921
San Juan, PR 00921
Phone
(787) 766-4646
NPI assigned
Jul 19, 2023
Last updated
Jul 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1492 PR Primary

Addresses

Primary practice location

00921 PR-21, San Juan, 00921
San Juan, PR 00921

Mailing address

52 Plaza Seis
Urb. Gran Vista 2
Gurabo, PR 00778
Phone (787) 469-1004

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

NPI Registry JSON

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1528748142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 PLAZA SEIS",
            "address_2": "URB. GRAN VISTA 2",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "00778",
            "telephone_number": "787-469-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "00921 PR-21, SAN JUAN, 00921",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00921",
            "telephone_number": "787-766-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA VICENTE",
        "first_name": "KEYLA",
        "middle_name": "NICOLE",
        "credential": "OTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "PR",
            "license": "1492",
            "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 Jul 19, 2023; 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.