Individual provider Active NPI

Adalisse Borges Hernandez, PH.D.

  • Clinical Psychologist
  • Toa Alta, PR
National Provider Identifier
1669415121
Registry record updated Jan 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2630 Issued in PR
Practice address
1710 Ave Palacios de Versalles
Palacios de Versalles
Toa Alta, PR 00953-6000
Phone
(787) 607-5666
NPI assigned
Jun 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2010

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 2630 PR Primary

Addresses

Primary practice location

1710 Ave Palacios de Versalles
Palacios de Versalles
Toa Alta, PR 00953-6000

Mailing address

1710 Ave Palacios de Versalles
Palacios de Versalles
Toa Alta, PR 00953-6000
Phone (787) 607-5666

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2630PRMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1669415121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 AVE PALACIOS DE VERSALLES",
            "address_2": "PALACIOS DE VERSALLES",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009536000",
            "telephone_number": "787-607-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 AVE PALACIOS DE VERSALLES",
            "address_2": "PALACIOS DE VERSALLES",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009536000",
            "telephone_number": "787-607-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGES HERNANDEZ",
        "first_name": "ADALISSE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "2630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Alta, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; 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.