Individual provider Active NPI

Jennifer M Garcia, PSYD

  • Clinical Psychologist
  • Canovanas, PR
National Provider Identifier
1912273053
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3878 Issued in PR
Practice address
66 B Ave Josefina Legrand
Esquina Palmer
Canovanas, PR 00729
Phone
(986) 378-7903
NPI assigned
Mar 22, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 3878 PR
Clinical Psychologist 103TC0700X 3878 PR Primary

Addresses

Primary practice location

66 B Ave Josefina Legrand
Esquina Palmer
Canovanas, PR 00729

Mailing address

1162 52 SE Street
Reparto Metropolitano
San Juan, PR 00921-2507
Phone (787) 506-2317

Other practice location 1

calle 601 Bloque 224
#10 Villa Carolina
Carolina, PR 00985
Phone (787) 762-6999

Other practice location 2

114 Carr 3
Guayama, PR 00784-6804
Phone (871) 878-7558

Other practice location 3

San Alfonso D12
Calle Mis Amores
Caguas, PR 00725-5821
Phone (787) 930-3144

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

LicenseStateTypeSpecialty
3878PRMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Psicologico Ilo, Inc. Clinical PastSince Feb 4, 2015 Accepting new patients
Centro Psicologico Ilo SE LLC Clinical PastSince Aug 13, 2023 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1912273053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1162 52 SE STREET",
            "address_2": "REPARTO METROPOLITANO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009212507",
            "telephone_number": "787-506-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 B AVE JOSEFINA LEGRAND",
            "address_2": "ESQUINA PALMER",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "00729",
            "telephone_number": "986-378-7903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "calle 601 Bloque 224",
            "address_2": "#10 Villa Carolina",
            "address_purpose": "LOCATION",
            "city": "Carolina",
            "state": "PR",
            "postal_code": "00985",
            "country_code": "US",
            "telephone_number": "787-762-6999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "114 Carr 3",
            "address_purpose": "LOCATION",
            "city": "Guayama",
            "state": "PR",
            "postal_code": "007846804",
            "country_code": "US",
            "telephone_number": "871-878-7558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "San Alfonso D12",
            "address_2": "Calle Mis Amores",
            "address_purpose": "LOCATION",
            "city": "Caguas",
            "state": "PR",
            "postal_code": "007255821",
            "country_code": "US",
            "telephone_number": "787-930-3144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "PR",
            "license": "3878",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canovanas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; 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.