Individual provider Active NPI

Maria Waleska Mirandes, PSY D

  • Clinical Psychologist
  • Juana Diaz, PR
National Provider Identifier
1629410956
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4020 Issued in PR
Practice address
Calle Pacifico K-128
Ur.B. Palacios del Prado
Juana Diaz, PR 00795
Phone
(787) 365-5543
NPI assigned
Jul 29, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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 4020 PR Primary

Addresses

Primary practice location

Calle Pacifico K-128
Ur.B. Palacios del Prado
Juana Diaz, PR 00795

Mailing address

Calle Pacifico K-128
Ur.B. Palacios del Prado
Juana Diaz, PR 00795
Phone (787) 365-5543

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": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1629410956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE PACIFICO K-128",
            "address_2": "UR.B. PALACIOS DEL PRADO",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "00795",
            "telephone_number": "787-365-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE PACIFICO K-128",
            "address_2": "UR.B. PALACIOS DEL PRADO",
            "city": "JUANA DIAZ",
            "state": "PR",
            "postal_code": "00795",
            "telephone_number": "787-365-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDES",
        "first_name": "MARIA",
        "middle_name": "WALESKA",
        "name_prefix": "Dr.",
        "credential": "PSY  D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-29",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "4020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juana Diaz, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.