Organization Active NPI

Jacqueline Chehebar-Valdes PHD PA

  • Clinical Neuropsychologist
  • Hollywood, FL
National Provider Identifier
1831177435
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY4945 Issued in FL
Legal business name
JACQUELINE CHEHEBAR-VALDES PHD PA
Practice address
2214 Hollywood Boulevard
Hollywood, FL 33020
Phone
(954) 927-9555
Fax
(954) 921-4604
NPI assigned
Jan 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2013

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

Authorized official

Name
Ashley Valdes
Title
Office Manager
Phone
(954) 927-9555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X PY4945 FL Primary

Addresses

Primary practice location

2214 Hollywood Boulevard
Hollywood, FL 33020

Mailing address

2214 Hollywood Boulevard
Hollywood, FL 33020
Phone (954) 927-9555

Other names 1

  • Jacqueline C Valdes, PhD PA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080424000634 FL Part B Supplier - Clinic/Group Practice 8729166160 Receives reassigned benefits from 2 practitioners
Practice locations: Hollywood, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1136332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369872000000",
    "number": "1831177435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 HOLLYWOOD BOULEVARD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33020",
            "telephone_number": "954-927-9555",
            "fax_number": "954-921-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 HOLLYWOOD BOULEVARD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33020",
            "telephone_number": "954-927-9555",
            "fax_number": "954-921-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE CHEHEBAR-VALDES PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-04",
        "last_updated": "2013-05-30",
        "status": "A",
        "authorized_official_last_name": "VALDES",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "954-927-9555"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY4945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacqueline C Valdes, PhD PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.