Active NPI
Jonaliz Lisboa
- Clinical Psychologist
- Cabo Rojo, PR
National Provider Identifier
1912637448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 7369
- Practice address
- Carr 100 KM 5.9
Cabo Rojo, PR 00623 - Phone
- (787) 306-1623
- NPI assigned
- Jun 16, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 7369 | PR | Primary |
Addresses
Primary practice location
Carr 100 KM 5.9
Cabo Rojo, PR 00623
Mailing address
HC 1 Box 9033
San Sebastian, PR 00685-6746
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230301001988 | PR | Practitioner - Clinical Psychologist | 9739562505 | Practice locations: Cabo Rojo, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7369 | PR | MD | Pediatrics Physician |
| 007369 | PR | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655337600000",
"number": "1912637448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 1 BOX 9033",
"city": "SAN SEBASTIAN",
"state": "PR",
"postal_code": "006856746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 100 KM 5.9",
"city": "CABO ROJO",
"state": "PR",
"postal_code": "00623",
"telephone_number": "787-306-1623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LISBOA",
"first_name": "JONALIZ",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-16",
"last_updated": "2022-06-16",
"certification_date": "2022-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "7369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cabo Rojo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.