NPIMap

Organization Active NPI

La Clinica de la Albizu Mayaguez

  • Clinical Psychologist
  • Mayaguez, PR
National Provider Identifier
1801205158
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
LA CLINICA DE LA ALBIZU MAYAGUEZ
Practice address
Carretera #64 Esquina Calle 3,
Urb Industrial Algarrobos
Mayaguez, PR 00680
Phone
(787) 838-7272
NPI assigned
Aug 11, 2014
Organization subpart
Yes
Parent organization
UNIVERSIDAD CARLOS ALBIZUAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Authorized official

Name
Dr. Maria C Bustillo, MSNPI 1568887784
Title
Clinical Director
Phone
(787) 725-6500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

Carretera #64 Esquina Calle 3,
Urb Industrial Algarrobos
Mayaguez, PR 00680

Mailing address

PO Box 9023711
San Juan, PR 00902-3711
Phone (787) 725-6500

Other practice location 1

151 Calle Tanca
San Juan, PR 00902-3711
Phone (787) 725-6500 ext. 1426

Other names 1

  • Universidad Carlos Albizu Other name

National Provider Directory

National Provider Directory
Tax ID family
La Clinica de la Albizu San Juan2 organizations share this tax ID, including this one
Part of
La Clinica de la Albizu San Juan

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629417600000",
    "number": "1801205158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9023711",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009023711",
            "telephone_number": "787-725-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA #64 ESQUINA CALLE 3,",
            "address_2": "URB INDUSTRIAL ALGARROBOS",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-838-7272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Calle Tanca",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "009023711",
            "country_code": "US",
            "telephone_number": "787-725-6500 x1426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LA CLINICA DE LA ALBIZU MAYAGUEZ",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSIDAD CARLOS ALBIZU",
        "enumeration_date": "2014-08-11",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-03",
        "status": "A",
        "authorized_official_last_name": "BUSTILLO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "787-725-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Universidad Carlos Albizu",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Universidad Carlos Albizu",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.