Active NPI
Fanny Charlayne Mateo Perez
- Counseling Psychologist
- San Juan, PR
National Provider Identifier
1609616556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 6829
- Practice address
- 463 Calle Fernando Calder # 212
San Juan, PR 00918-2769 - Phone
- (787) 612-9790
- NPI assigned
- May 29, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6829 | PR | |
| Counseling Psychologist | 103TC1900X | 6829 | Primary |
Addresses
Primary practice location
463 Calle Fernando Calder # 212
San Juan, PR 00918-2769
Mailing address
274 Calle Canals Apt 801
San Juan, PR 00907-3002
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6829 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716940800000",
"number": "1609616556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "274 CALLE CANALS APT 801",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009073002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "463 CALLE FERNANDO CALDER # 212",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009182769",
"telephone_number": "787-612-9790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATEO PEREZ",
"first_name": "FANNY",
"middle_name": "CHARLAYNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-29",
"last_updated": "2024-05-29",
"certification_date": "2024-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PR",
"license": "6829",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": null,
"license": "6829",
"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 May 29, 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.