Active NPI
Ruth Johanna Lopez, LIC.
- Counseling Psychologist
- Dorado, PR
National Provider Identifier
1942570882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 4134
- Practice address
- Urb. Sabanera Dorado
# 484 Camino El Yunque
Dorado, PR 00646 - Phone
- (787) 960-4748
- Fax
- (787) 796-8529
- NPI assigned
- Jan 10, 2012
- 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 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | |||
| Psychologist | 103T00000X | |||
| Adult Development & Aging Psychologist | 103TA0700X | |||
| Cognitive & Behavioral Psychologist | 103TB0200X | |||
| Family Psychologist | 103TF0000X | |||
| Rehabilitation Psychologist | 103TR0400X | |||
| Counseling Psychologist | 103TC1900X | 4134 | PR | Primary |
Addresses
Primary practice location
Urb. Sabanera Dorado
# 484 Camino El Yunque
Dorado, PR 00646
Mailing address
Urb. Sabanera Dorado
# 484 Camino El Yunque
Dorado, PR 00646-3640
Phone (787) 960-4748
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4134 | PR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527206400000",
"number": "1942570882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB. SABANERA DORADO",
"address_2": "# 484 CAMINO EL YUNQUE",
"city": "DORADO",
"state": "PR",
"postal_code": "006463640",
"telephone_number": "787-960-4748",
"fax_number": "787-946-4414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "URB. SABANERA DORADO",
"address_2": "# 484 CAMINO EL YUNQUE",
"city": "DORADO",
"state": "PR",
"postal_code": "00646",
"telephone_number": "787-960-4748",
"fax_number": "787-796-8529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "RUTH",
"middle_name": "JOHANNA",
"credential": "LIC.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-10",
"last_updated": "2018-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "PR",
"license": "4134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dorado, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.