Active NPI
Diana Teresa Domenech, PSIC
- Counseling Psychologist
- Bayamon, PR
National Provider Identifier
1922516004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 5920
- Practice address
- Mo17 Paseo del Valle
Bayamon, PR 00961-3539 - Phone
- (787) 467-8878
- NPI assigned
- Jan 11, 2018
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 5920 | PR | Primary |
Addresses
Primary practice location
Mo17 Paseo del Valle
Bayamon, PR 00961-3539
Mailing address
Mo17 Paseo del Valle
Bayamon, PR 00961-3539
Phone (787) 467-8878
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5920 | Other | PR | PSIC NUMBER |
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 |
|---|---|---|---|
| 5920 | PR | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515628800000",
"number": "1922516004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MO17 PASEO DEL VALLE",
"city": "BAYAMON",
"state": "PR",
"postal_code": "009613539",
"telephone_number": "787-467-8878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MO17 PASEO DEL VALLE",
"city": "BAYAMON",
"state": "PR",
"postal_code": "009613539",
"telephone_number": "787-467-8878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMENECH",
"first_name": "DIANA",
"middle_name": "TERESA",
"name_prefix": "Mrs.",
"credential": "PSIC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-11",
"last_updated": "2018-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Counseling",
"state": "PR",
"license": "5920",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSIC NUMBER",
"identifier": "5920",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bayamon, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.