Individual provider Active NPI

Gelitza Caraballo, PSY.D.

  • Clinical Psychologist
  • Ponce, PR
National Provider Identifier
1578719522
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3087 Issued in PR
Practice address
1224 Ave Munoz Rivera
Reparto Universitario
Ponce, PR 00717-0639
Phone
(787) 901-7257
NPI assigned
Aug 11, 2008
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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 3087 PR Primary

Addresses

Primary practice location

1224 Ave Munoz Rivera
Reparto Universitario
Ponce, PR 00717-0639

Mailing address

1224 Ave Munoz Rivera
Reparto Universitario
Ponce, PR 00717-0639
Phone (787) 901-7257

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
3087PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1578719522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 AVE MUNOZ RIVERA",
            "address_2": "REPARTO UNIVERSITARIO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007170639",
            "telephone_number": "787-901-7257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 AVE MUNOZ RIVERA",
            "address_2": "REPARTO UNIVERSITARIO",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007170639",
            "telephone_number": "787-901-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARABALLO",
        "first_name": "GELITZA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-11",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.