Individual provider Active NPI

Paola Marie Perez Candelaria

  • Clinical Social Worker
  • San Juan, PR
National Provider Identifier
1962855361
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13113 Issued in PR
Practice address
1256 Calle Cairo
Urbanizacion Puerto Nuevo
San Juan, PR 00920-3838
Phone
(787) 923-2412
NPI assigned
Jul 20, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13113 PR Primary

Addresses

Primary practice location

1256 Calle Cairo
Urbanizacion Puerto Nuevo
San Juan, PR 00920-3838

Mailing address

860 Carr 175 Apt 1204
San Juan, PR 00926-8247
Phone (787) 923-2412

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

LicenseStateTypeSpecialty
13113PRMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1962855361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 CARR 175 APT 1204",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009268247",
            "telephone_number": "787-923-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1256 CALLE CAIRO",
            "address_2": "URBANIZACION PUERTO NUEVO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009203838",
            "telephone_number": "787-923-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ CANDELARIA",
        "first_name": "PAOLA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-20",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PR",
            "license": "13113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.