Individual provider Active NPI

Lysandra Alvarez Nieves, PSY D.

  • Clinical Psychologist
  • San Juan, PR
National Provider Identifier
1831461292
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3845 Issued in PR
Practice address
1698 Calle Cuernavaca
Venus Gardens
San Juan, PR 00926-4728
Phone
(787) 236-0107
NPI assigned
Feb 1, 2012
Last updated
Jan 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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 3845 PR Primary

Addresses

Primary practice location

1698 Calle Cuernavaca
Venus Gardens
San Juan, PR 00926-4728

Mailing address

1698 Calle Cuernavaca
Venus Gardens
San Juan, PR 00926-4728
Phone (787) 236-0107

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1831461292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 CALLE CUERNAVACA",
            "address_2": "VENUS GARDENS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009264728",
            "telephone_number": "787-236-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1698 CALLE CUERNAVACA",
            "address_2": "VENUS GARDENS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009264728",
            "telephone_number": "787-236-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ NIEVES",
        "first_name": "LYSANDRA",
        "name_prefix": "Dr.",
        "credential": "PSY D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-01",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3845",
            "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 Jan 23, 2020; 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.