Individual provider Active NPI

Waleska Maldonado, PH.D, MRC

  • Clinical Psychologist
  • Bayamon, PR
National Provider Identifier
1871135749
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6664 Issued in PR
Practice address
68 Calle Esteban Padilla
Bayamon, PR 00959-6705
Phone
(939) 248-3845
NPI assigned
Oct 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 225C00000X 1363
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 6664 PR Primary

Addresses

Primary practice location

68 Calle Esteban Padilla
Bayamon, PR 00959-6705

Mailing address

HC 91 Box 9178
Vega Alta, PR 00692-9675
Phone (939) 248-3845

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6664PRMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1570838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1871135749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 91 BOX 9178",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006929675",
            "telephone_number": "939-248-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 CALLE ESTEBAN PADILLA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009596705",
            "telephone_number": "939-248-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "WALESKA",
        "name_prefix": "Dr.",
        "credential": "PH.D, MRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-12",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": "1363",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "6664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2022; 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.