Active NPI
Joel Manzano, PH.D
- Clinical Psychologist
- Gurabo, PR
National Provider Identifier
1942523170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3265
- Practice address
- 483 Vereda de Las Amapolas
Urb Veredas
Gurabo, PR 00778-9692 - Phone
- (787) 397-9031
- NPI assigned
- Mar 2, 2010
- Sex
- Male
- 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 | 3265 | PR | Primary |
Addresses
Primary practice location
483 Vereda de Las Amapolas
Urb Veredas
Gurabo, PR 00778-9692
Mailing address
483 Vereda de Las Amapolas
Urb Veredas
Gurabo, PR 00778-9692
Phone (787) 397-9031
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3265 | PR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267488000000",
"number": "1942523170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "483 VEREDA DE LAS AMAPOLAS",
"address_2": "URB VEREDAS",
"city": "GURABO",
"state": "PR",
"postal_code": "007789692",
"telephone_number": "787-397-9031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "483 VEREDA DE LAS AMAPOLAS",
"address_2": "URB VEREDAS",
"city": "GURABO",
"state": "PR",
"postal_code": "007789692",
"telephone_number": "787-397-9031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANZANO",
"first_name": "JOEL",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-02",
"last_updated": "2010-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "3265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gurabo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.