Individual provider Active NPI

Ivonne Marie Villate, PSY.D.

  • Clinical Psychologist
  • Guaynabo, PR
National Provider Identifier
1811292873
Registry record updated Jan 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1594 Issued in PR
Practice address
#20 Pineiro
Suite 201
Guaynabo, PR 00969
Phone
(787) 790-6448
NPI assigned
Jan 21, 2011
Last updated
Jan 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1594 PR Primary

Addresses

Primary practice location

#20 Pineiro
Suite 201
Guaynabo, PR 00969

Mailing address

An35 Plaza San Vicente
Antillana
Trujillo Alto, PR 00976-6128
Phone (787) 644-5497

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
1594PRMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295568000000",
    "number": "1811292873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AN35 PLAZA SAN VICENTE",
            "address_2": "ANTILLANA",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009766128",
            "telephone_number": "787-644-5497",
            "fax_number": "787-790-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#20 PINEIRO",
            "address_2": "SUITE 201",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-790-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLATE",
        "first_name": "IVONNE",
        "middle_name": "MARIE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-21",
        "last_updated": "2011-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "1594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.