Centro de Apoyo Integrado Y Kinesiologia Energetica Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

CENTRO DE APOYO INTEGRADO Y KINESIOLOGIA ENERGETICA INC

Practice address

Condominio Darlington
1007 Ave. Munoz Rivera, Suite 1200
San Juan, PR 00925-2726

Phone

(787) 930-9942

NPI assigned

Jun 14, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Wanda Pacheco Bou, PHD

Title

Executive Director

Phone

(787) 633-1382

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mayra Nevares, PH.D.

  • Clinical Psychologist
  • San Juan, PR
  • NPI 1245450584

  Clinical, PR

  Medicare reassignment NPD
• Paloma Torres-Davila, PHD

  • Psychologist
  • Bayamon, PR
  • NPI 1073339909

  PR

  Medicare reassignment NPD
• Roberto Fernandez-Vargas, MA

  • Psychologist
  • San Juan, PR
  • NPI 1710794052
  NPD

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1982447223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COND DARLINGTON",
            "address_2": "1007 AVE. MUNOZ RIVERA, SUITE 1201",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009252726",
            "telephone_number": "787-930-9942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CONDOMINIO DARLINGTON",
            "address_2": "1007 AVE. MUNOZ RIVERA, SUITE 1200",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009252726",
            "telephone_number": "787-930-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DE APOYO INTEGRADO Y KINESIOLOGIA ENERGETICA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-14",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "PACHECO BOU",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "787-633-1382",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in San Juan, PR
• Clinical Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.