Individual provider Active NPI

Jessica Perez

  • Intellectual & Developmental Disabilities Psychologist
  • Ponce, PR
National Provider Identifier
1710869094
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
License
6684 Issued in PR
Practice address
Villa del Carmen
Calle Salamanca 509
Ponce, PR 00730
Phone
(787) 601-2989
NPI assigned
Jul 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X 6684 PR Primary

Addresses

Primary practice location

Villa del Carmen
Calle Salamanca 509
Ponce, PR 00730

Mailing address

Villa del Carmen
Calle Salamanca 509
Ponce, PR 00730
Phone (787) 601-2989

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

State licenses

LicenseStateTypeSpecialty
6684PRMDIntellectual & Developmental Disabilities Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1753401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1710869094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "VILLA DEL CARMEN",
            "address_2": "CALLE SALAMANCA 509",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00730",
            "telephone_number": "787-601-2989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VILLA DEL CARMEN",
            "address_2": "CALLE SALAMANCA 509",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00730",
            "telephone_number": "787-601-2989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-25",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "PR",
            "license": "6684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; 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.