Sui Generis Clinica de Servicios Psicologicos P.S.C.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3962 Issued in PR

Legal business name

SUI GENERIS CLINICA DE SERVICIOS PSICOLOGICOS P.S.C.

Practice address

47 Calle Munoz Rivera
Toal Alta, PR 00953

Phone

(939) 338-1984

NPI assigned

Oct 21, 2015

Last updated

Oct 21, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Angela M Taboas

Title

President

Phone

(787) 613-1744

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445385600000",
    "number": "1669844338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 CALLE MUNOZ RIVERA",
            "city": "TOAL ALTA",
            "state": "PR",
            "postal_code": "00953",
            "telephone_number": "939-338-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 CALLE MUNOZ RIVERA",
            "city": "TOAL ALTA",
            "state": "PR",
            "postal_code": "00953",
            "telephone_number": "939-338-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUI GENERIS CLINICA DE SERVICIOS PSICOLOGICOS P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-21",
        "last_updated": "2015-10-21",
        "status": "A",
        "authorized_official_last_name": "TABOAS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-613-1744",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "364SX0106X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Occupational Health",
            "state": "PR",
            "license": "500",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "3962",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PR",
            "license": "3001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; 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.