Individual provider Active NPI

Jose Rafael Velez Santiago, PSY-D

  • Clinical Psychologist
  • San Juan, PR
National Provider Identifier
1982832366
Registry record updated Jun 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3412 Issued in PR
Practice address
1790 Calle Julio Aybar
Urb. Santiago Iglesias
San Juan, PR 00921-4410
Phone
(787) 983-4883
Fax
(787) 993-2229
NPI assigned
Jun 24, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3412 PR Primary

Addresses

Primary practice location

1790 Calle Julio Aybar
Urb. Santiago Iglesias
San Juan, PR 00921-4410

Mailing address

676 Calle Cupido
Venus Garden
San Juan, PR 00926-4804
Phone (787) 983-4883

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
3412PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1982832366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 CALLE CUPIDO",
            "address_2": "VENUS GARDEN",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009264804",
            "telephone_number": "787-983-4883",
            "fax_number": "787-993-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 CALLE JULIO AYBAR",
            "address_2": "URB. SANTIAGO IGLESIAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009214410",
            "telephone_number": "787-983-4883",
            "fax_number": "787-993-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELEZ SANTIAGO",
        "first_name": "JOSE",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "PSY-D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3412",
            "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 Jun 24, 2009; 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.