Active NPI
Jessica Marie Perez Gonzalez, PSY D.
- Clinical Psychologist
- Carolina, PR
National Provider Identifier
1912148263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3281
- Practice address
- Ave. Campo Rico GJ-15 Suite 201
Carolina, PR 00982 - Phone
- (787) 461-1659
- NPI assigned
- Mar 17, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3281 | PR | Primary |
Addresses
Primary practice location
Ave. Campo Rico GJ-15 Suite 201
Carolina, PR 00982
Mailing address
Ave. Campo Rico GJ-15 Suite 201
Carolina, PR 00982
Phone (787) 461-1659
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 |
|---|---|---|---|
| 3281 | PR | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237248000000",
"number": "1912148263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "AVE. CAMPO RICO GJ-15 SUITE 201",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00982",
"telephone_number": "787-461-1659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "AVE. CAMPO RICO GJ-15 SUITE 201",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00982",
"telephone_number": "787-461-1659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ GONZALEZ",
"first_name": "JESSICA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PSY D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-17",
"last_updated": "2009-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "3281",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carolina, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.