Individual provider Active NPI

Astrid Erismann-Dubocq, PHD

  • Clinical Psychologist
  • Cayey, PR
National Provider Identifier
1831666080
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6051 Issued in PR
Practice address
Hospital Menonita Cima
Plaza Cayey Montellanos
Cayey, PR 00736-3801
Phone
(787) 664-1074
NPI assigned
Oct 25, 2018
Last updated
Oct 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 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 6051 PR Primary

Addresses

Primary practice location

Hospital Menonita Cima
Plaza Cayey Montellanos
Cayey, PR 00736-3801

Mailing address

PO Box 3681
Guaynabo, PR 00970-3681
Phone (787) 664-1074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6051PRMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1831666080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3681",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009703681",
            "telephone_number": "787-664-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL MENONITA CIMA",
            "address_2": "PLAZA CAYEY MONTELLANOS",
            "city": "CAYEY",
            "state": "PR",
            "postal_code": "007363801",
            "telephone_number": "787-664-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERISMANN-DUBOCQ",
        "first_name": "ASTRID",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-25",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "6051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cayey, PR

Sources for this page

Verify at the official NPI Registry.