Individual provider Active NPI

Daisy Pascualvaca, PH.D.

  • Clinical Neuropsychologist
  • Washington, DC
National Provider Identifier
1578812921
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
2911 Issued in MD
Practice address
3301 New Mexico Ave NW
Suite 221
Washington, DC 20016-3622
Phone
(202) 537-6155
Fax
(202) 537-6055
NPI assigned
Aug 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 2911 MD Primary
Clinical Neuropsychologist 103G00000X 1632 DC

Addresses

Primary practice location

3301 New Mexico Ave NW
Suite 221
Washington, DC 20016-3622

Mailing address

3301 New Mexico Ave NW
Suite 221
Washington, DC 20016-3622
Phone (202) 537-6155

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1632DCMDClinical Neuropsychologist
2911MDMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1578812921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 NEW MEXICO AVE NW",
            "address_2": "SUITE 221",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200163622",
            "telephone_number": "202-537-6155",
            "fax_number": "202-537-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 NEW MEXICO AVE NW",
            "address_2": "SUITE 221",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200163622",
            "telephone_number": "202-537-6155",
            "fax_number": "202-537-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCUALVACA",
        "first_name": "DAISY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MD",
            "license": "2911",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "DC",
            "license": "1632",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.