Individual provider Active NPI

Jennifer Cardona Prieto, PSYD

  • Clinical Psychologist
  • Ponce, PR
National Provider Identifier
1891427175
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7325 Issued in PR
Practice address
Carr. 123 KM 11.8 Bo Magueyes, Granada Hill
Ponce, PR 00730
Phone
(939) 328-1757
NPI assigned
Jun 27, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 7325 PR Primary

Addresses

Primary practice location

Carr. 123 KM 11.8 Bo Magueyes, Granada Hill
Ponce, PR 00730

Mailing address

PO Box 10025
Ponce, PR 00732-0025
Phone (939) 328-1757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231101003094 PR Practitioner - Clinical Psychologist 5395191993 Practice locations: Ponce, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7325PRMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1891427175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10025",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007320025",
            "telephone_number": "939-328-1757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 123 KM 11.8 BO MAGUEYES, GRANADA HILL",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00730",
            "telephone_number": "939-328-1757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDONA PRIETO",
        "first_name": "JENNIFER",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "7325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.