Individual provider Active NPI

Susana Vazquez Lugo, PH.D

  • Psychologist
  • Hato Rey, PR
National Provider Identifier
1780673533
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1831 Issued in PR
Practice address
Ave. Domenech 207
Oficina 108
Hato Rey, PR 00918
Phone
(787) 274-5100
Fax
(787) 274-5115
NPI assigned
Oct 14, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1831 PR Primary

Addresses

Primary practice location

Ave. Domenech 207
Oficina 108
Hato Rey, PR 00918

Mailing address

2000 Carr 8177
Suite 26 PMB 138
Guaynabo, PR 00966-3733
Phone (787) 640-6585

Other identifiers 4

IdentifierTypeStateIssuer
HM0LPOS2611OtherAPS
100572OtherCRUZ AZUL
2581OtherREFORMA
2611OtherPPO

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

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294876800000",
    "number": "1780673533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 CARR 8177",
            "address_2": "SUITE 26 PMB 138",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009663733",
            "telephone_number": "787-640-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. DOMENECH 207",
            "address_2": "OFICINA 108",
            "city": "HATO REY",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-274-5100",
            "fax_number": "787-274-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ LUGO",
        "first_name": "SUSANA",
        "name_prefix": "Mrs.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-14",
        "last_updated": "2011-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "1831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APS",
            "identifier": "HM0LPOS2611",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL",
            "identifier": "100572",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REFORMA",
            "identifier": "2581",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPO",
            "identifier": "2611",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hato Rey, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; 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.