Agnes S Diaz, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4105 Issued in PR

Practice address

788 Ave San Patricio
San Juan, PR 00921-1303

Phone

(787) 550-9708

NPI assigned

Dec 19, 2011

Last updated

Mar 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eos: Psychological Wellness Centre

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carolina, PR
  • NPI 1003188244
  NPD (past) Authorized official

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1851660914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AF24 CALLE 31",
            "address_2": "URB. INTERAMERICANA",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009763411",
            "telephone_number": "787-550-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 AVE SAN PATRICIO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009211303",
            "telephone_number": "787-550-9708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "AGNES",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-19",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "4105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Porfirio Ernesto Diaz-Rodriguez, MD
• Yahaira Noemi Diaz-Rodriguez, M.D.
• Edgar Diaz-Ruiz, DDS
• Lorena Diaz-Trancon, M.D.
• Lucy Diaz-Valcarcel, M.D.
• Alejandro Diaz, O.D.
• Alwin E. Diaz
• Ana I Diaz, LPN
• Analid T. Diaz, MD
• Anita Diaz, M.D.

• Clinical Psychologist in San Juan, PR
• Providers in San Juan, PR by specialty
• Clinical Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.