Julissa Lopez Santiago, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3579 Issued in PR

Practice address

7174 Calle Divina Providencia
Urb Santa Maria
Ponce, PR 00717

Phone

(787) 629-7006

NPI assigned

Mar 7, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1962776914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7174 CALLE DIVINA PROVIDENCIA",
            "address_2": "URB SANTA MARIA",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00717",
            "telephone_number": "787-629-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7174 CALLE DIVINA PROVIDENCIA",
            "address_2": "URB SANTA MARIA",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00717",
            "telephone_number": "787-629-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ SANTIAGO",
        "first_name": "JULISSA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "3579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raul Miguel Lopez Pineiro
• Alejandra Lopez Ramos
• Alma Rosa Lopez Rivera, PSYD
• Teodoro Lopez Rivera, D.M.D., MSCD.
• Yadira Lopez Rivera
• Hector Samuel Lopez Vega
• Maylin Yeliksa Lopez-Cortes, M.D.
• Dorimar Lopez-Hernandez
• Alejandro Jose Lopez-Mas, M.D.
• Maritza Lopez-Montalvo, M.D.

• Psychologist in Ponce, PR
• Providers in Ponce, PR by specialty
• Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.

Verify at the official NPI Registry.