Active NPI
Myriam Gonzalez, PSY. D.
- Clinical Psychologist
National Provider Identifier
1992008817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 678
- Practice address
- Condominio Playa Dorada Apartamento 616 B
7043 Carretera 187
Carolina, PR 00979
UM - Phone
- (787) 536-1317
- Fax
- (787) 200-5149
- NPI assigned
- Dec 15, 2010
- Last updated
- Dec 15, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 678 | PR | Primary |
Addresses
Primary practice location
Condominio Playa Dorada Apartamento 616 B
7043 Carretera 187
Carolina, PR 00979
UM
Mailing address
Condominio Playa Dorada Apartamento 616 B
7043 Carretera 187
Carolina, PR 00979
UM
Phone (787) 536-1317
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
| License | State | Type | Specialty |
|---|---|---|---|
| 678 | PR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hector J Guerra | Clinical | Past | Accepting new patients |
| New Health Med Group Inc | Clinical | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Carolina, PR
- NPI 1295919231
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292371200000",
"number": "1992008817",
"addresses": [
{
"country_code": "UM",
"country_name": "United States Minor Outlying Islands",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "CONDOMINIO PLAYA DORADA APARTAMENTO 616 B",
"address_2": "7043 CARRETERA 187",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00979",
"telephone_number": "787-536-1317",
"fax_number": "787-200-5149"
},
{
"country_code": "UM",
"country_name": "United States Minor Outlying Islands",
"address_purpose": "LOCATION",
"address_type": "FGN",
"address_1": "CONDOMINIO PLAYA DORADA APARTAMENTO 616 B",
"address_2": "7043 CARRETERA 187",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00979",
"telephone_number": "787-536-1317",
"fax_number": "787-200-5149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "MYRIAM",
"name_prefix": "Dr.",
"credential": "PSY. D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-15",
"last_updated": "2010-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.