Vanessa I. Boglio Martinez, PSY D
Individual provider Active NPI Clinical Psychologist · Santurce, PR
NPI 1831258680 · NPPES record last updated Aug 22, 2017
Key facts
- NPI
- 1831258680
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 2629 (PR)
- Practice address
- 1607 Ave Ponce de Leon
Edificion Cobian'S Plaza Suite 301
Santurce, PR 00909-1820 - Phone
- (787) 236-8733
- NPI assigned
- Dec 7, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070222000048 | PR | Practitioner - Clinical Psychologist | 0547362543 | Practice locations: San Juan, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2629 | PR | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2629 | PR | Yes |
Addresses
Primary practice location
1607 Ave Ponce de Leon
Edificion Cobian'S Plaza Suite 301
Santurce, PR 00909-1820
Mailing address
1019 Ave Luis Vigoreaux
Condominio Doral Plaza I Apt. E-2
Guaynabo, PR 00966-2400
Phone (787) 236-8733
Other providers in Santurce, PR
- Evelyn Baez
- Maria Elisa Ballester
- Lilymar Benitez
- Ivelisse Marie Berrios Lopez
- Benjamin Betancourt
- Melvin A Bonilla-Felix
- Maria N. Borrero
- Ruben Borrero
- Brain & Behavior Consulting LLC
- C&J Medical Group
All providers in Santurce, PR · Clinical Psychologist in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.