Active NPI
Edna E Rodriguez, CLINICAL PSYCHOLOGIS
- Psychologist
- San Juan, PR
National Provider Identifier
1811192750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 000739
- Practice address
- Calle Ronda a 21
San Juan, PR 00926 - Phone
- (787) 755-3290
- Fax
- (787) 755-3290
- NPI assigned
- Jun 20, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 000739 | PR | Primary |
Addresses
Primary practice location
Calle Ronda a 21
San Juan, PR 00926
Mailing address
PO Box 364582
San Juan, PR 00936-4582
Phone (787) 755-3290
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
| License | State | Type | Specialty |
|---|---|---|---|
| 000739 | PR | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811192750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 364582",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009364582",
"telephone_number": "787-755-3290",
"fax_number": "787-755-3290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CALLE RONDA A 21",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00926",
"telephone_number": "787-755-3290",
"fax_number": "787-755-3290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "EDNA",
"middle_name": "E",
"credential": "CLINICAL PSYCHOLOGIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PR",
"license": "000739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.