Active NPI
Guadalupe Avila, MS
- School Psychologist
- New Rochelle, NY
National Provider Identifier
1790093565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 2127083
- Practice address
- 5 Prospect St Apt 2R
New Rochelle, NY 10805-2828 - Phone
- (914) 576-3682
- NPI assigned
- Sep 15, 2010
- Last updated
- Sep 15, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 2127083 | NY | Primary |
Addresses
Primary practice location
5 Prospect St Apt 2R
New Rochelle, NY 10805-2828
Mailing address
5 Prospect St Apt 2R
New Rochelle, NY 10805-2828
Phone (914) 576-3682
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 58195-9781 | Medicaid | NY |
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2127083 | NY | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284508800000",
"number": "1790093565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 PROSPECT ST APT 2R",
"city": "NEW ROCHELLE",
"state": "NY",
"postal_code": "108052828",
"telephone_number": "914-576-3682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 PROSPECT ST APT 2R",
"city": "NEW ROCHELLE",
"state": "NY",
"postal_code": "108052828",
"telephone_number": "914-576-3682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVILA",
"first_name": "GUADALUPE",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-15",
"last_updated": "2010-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NY",
"license": "2127083",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "58195-9781",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Rochelle, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.