Individual provider Active NPI

Cristina Charisse Feliciano-Matos, PSY.D.

  • Clinical Psychologist
  • Fort Worth, TX
National Provider Identifier
1962641852
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY12830 Issued in FL
Practice address
3109 Dixondale Dr
Fort Worth, TX 76108-2477
Phone
(787) 528-7593
NPI assigned
Feb 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X TX
Clinical Psychologist 103TC0700X PY12830 FL Primary
Clinical Psychologist 103TC0700X 3327 PR

Addresses

Primary practice location

3109 Dixondale Dr
Fort Worth, TX 76108-2477

Mailing address

3109 Dixondale Dr
Fort Worth, TX 76108-2477
Phone (787) 528-7593

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

LicenseStateTypeSpecialty
PY12830FLMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1962641852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 DIXONDALE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761082477",
            "telephone_number": "787-528-7593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 DIXONDALE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761082477",
            "telephone_number": "787-528-7593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELICIANO-MATOS",
        "first_name": "CRISTINA",
        "middle_name": "CHARISSE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-17",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY12830",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3327",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.