Active NPI
Omar Rosa Jimenez, M.A.
- Psychologist
- Arecibo, PR
National Provider Identifier
1689850943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2361
- Practice address
- Bo. Garrochales
Job Corps
Arecibo, PR 00612 - Phone
- (787) 594-6949
- NPI assigned
- Jan 17, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2361 | PR | Primary |
Addresses
Primary practice location
Bo. Garrochales
Job Corps
Arecibo, PR 00612
Mailing address
HC 03 Box 36116
San Sebastian, PR 00685
Phone (787) 594-6940
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2361 | PR | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200528000000",
"number": "1689850943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 03 BOX 36116",
"city": "SAN SEBASTIAN",
"state": "PR",
"postal_code": "00685",
"telephone_number": "787-594-6940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BO. GARROCHALES",
"address_2": "JOB CORPS",
"city": "ARECIBO",
"state": "PR",
"postal_code": "00612",
"telephone_number": "787-594-6949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSA JIMENEZ",
"first_name": "OMAR",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-17",
"last_updated": "2008-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PR",
"license": "2361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arecibo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.