Individual provider Active NPI

Aysha N. Gonzalez Santiago, PSYD

  • Clinical Psychologist
  • Cabo Rojo, PR
National Provider Identifier
1558785972
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6062 Issued in PR
Practice address
Urb. Monte Rio 124 Calle Yaguez
Cabo Rojo, PR 00623
Phone
(787) 560-6930
NPI assigned
Feb 5, 2014
Last updated
Jul 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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 6062 PR Primary

Addresses

Primary practice location

Urb. Monte Rio 124 Calle Yaguez
Cabo Rojo, PR 00623

Mailing address

Urb. Monte Rio 124 Calle Yaguez
Cabo Rojo, PR 00623
Phone (787) 560-6930

Other practice location 1

697 Santa Teresa Journet Ave Sur
Mayaguez, PR 00680
Phone (787) 641-0773

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

LicenseStateTypeSpecialty
6062PRMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1558785972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. MONTE RIO 124 CALLE YAGUEZ",
            "city": "CABO ROJO",
            "state": "PR",
            "postal_code": "00623",
            "telephone_number": "787-560-6930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. MONTE RIO 124 CALLE YAGUEZ",
            "city": "CABO ROJO",
            "state": "PR",
            "postal_code": "00623",
            "telephone_number": "787-560-6930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "697 Santa Teresa Journet Ave Sur",
            "address_purpose": "LOCATION",
            "city": "Mayaguez",
            "state": "PR",
            "postal_code": "00680",
            "country_code": "US",
            "telephone_number": "787-641-0773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ SANTIAGO",
        "first_name": "AYSHA",
        "middle_name": "N.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-05",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "6062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cabo Rojo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; 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.