Active NPI
Jennifer Bernabe, LIC OPTICIAN
- Speech-Language Pathologist
- Ciales, PR
National Provider Identifier
1891934501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4309
- Practice address
- Calle Jose de Diego # 39a
Ciales, PR 00638 - Phone
- (787) 526-0833
- NPI assigned
- Feb 19, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 000635 | PR | |
| Speech-Language Pathologist | 235Z00000X | 4309 | PR | Primary |
Addresses
Primary practice location
Calle Jose de Diego # 39a
Ciales, PR 00638
Mailing address
Urb. Guarico C/B Casa G#8 Vega Baja
Vega Baja, PR 00693
Phone (787) 627-5818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 660724348 | Other | PR | PMC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4309 | PR | MD | Professional Counselor |
| 000635 | PR | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625529600000",
"number": "1891934501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB. GUARICO C/B CASA G#8 VEGA BAJA",
"city": "VEGA BAJA",
"state": "PR",
"postal_code": "00693",
"telephone_number": "787-627-5818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CALLE JOSE DE DIEGO # 39A",
"city": "CIALES",
"state": "PR",
"postal_code": "00638",
"telephone_number": "787-526-0833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNABE",
"first_name": "JENNIFER",
"name_prefix": "Mrs.",
"credential": "LIC OPTICIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-19",
"last_updated": "2021-07-06",
"certification_date": "2021-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "PR",
"license": "000635",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PR",
"license": "4309",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PMC",
"identifier": "660724348",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ciales, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.