Active NPI
Ileana De Jesus Santiago, PH.D.
- Clinical Psychologist
- San Juan, PR
National Provider Identifier
1942540067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 004677
- Practice address
- 1626 Calle Indo
Urb. El Cerezal
San Juan, PR 00926-3031 - Phone
- (787) 342-2948
- NPI assigned
- Feb 26, 2013
- 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 | 004677 | PR | Primary |
Addresses
Primary practice location
1626 Calle Indo
Urb. El Cerezal
San Juan, PR 00926-3031
Mailing address
1626 Calle Indo
Urb. El Cerezal
San Juan, PR 00926-3031
Phone (787) 342-2948
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 |
|---|---|---|---|
| 004677 | PR | MD | Clinical Psychologist |
| 4677 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361836800000",
"number": "1942540067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1626 CALLE INDO",
"address_2": "URB. EL CEREZAL",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009263031",
"telephone_number": "787-342-2948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1626 CALLE INDO",
"address_2": "URB. EL CEREZAL",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009263031",
"telephone_number": "787-342-2948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE JESUS SANTIAGO",
"first_name": "ILEANA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-02-26",
"last_updated": "2013-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "004677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
- Jorge R De Jesus Miranda, MD
- Nelson De Jesus Ramos, M.D.
- Carmen C De Jesus Rivera, MD
- Edgar Alexis De Jesus Rodriguez, MD
- Evony Coral De Jesus Santa
- Maria Angelica De Jesus Sosa, PT, DPT
- Stephanie I. De Jesus Soto, RN
- Blanca N De Jesus Valiente, M.D.
- Jaime De Jesus Vinas, D.M.D., M.S.
- Wilfredo Eugenio De Jesus-Monge, M.D., M.SC.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.