Individual provider Active NPI

Ana Mirian Quinones Maldonado, PHD

  • Clinical Psychologist
  • Carolina, PR
National Provider Identifier
1710464243
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6546 Issued in PR
Practice address
Paseo de Los Gigantes, Ab 18, Local 5
Valle Arriba Heights
Carolina, PR 00987
Phone
(939) 222-0752
NPI assigned
Jul 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X 6546 PR Primary

Addresses

Primary practice location

Paseo de Los Gigantes, Ab 18, Local 5
Valle Arriba Heights
Carolina, PR 00987

Mailing address

514 Paseo Zumbador
Coto Laurel, PR 00780-2410
Phone (787) 463-4595

Other practice location 1

2121 W Temple St
Los Angeles, CA 90026-4915
Phone (213) 385-5100

Other identifiers 1

IdentifierTypeStateIssuer
4846697OtherPRPR DRIVER'S LICENSE

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
6546PRMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1710464243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 PASEO ZUMBADOR",
            "city": "COTO LAUREL",
            "state": "PR",
            "postal_code": "007802410",
            "telephone_number": "787-463-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PASEO DE LOS GIGANTES, AB 18, LOCAL 5",
            "address_2": "VALLE ARRIBA HEIGHTS",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00987",
            "telephone_number": "939-222-0752"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 W Temple St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900264915",
            "country_code": "US",
            "telephone_number": "213-385-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINONES MALDONADO",
        "first_name": "ANA",
        "middle_name": "MIRIAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2021-09-01",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "6546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PR DRIVER'S LICENSE",
            "identifier": "4846697",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.