Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 4121 | PR |
N | 103T00000X | Psychologist | 4121 | PR |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 4121 | PR |
N | 103TA0700X | Adult Development & Aging Psychologist | 4121 | PR |
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
Y | 103G00000X | Clinical Psychologist | 4121 | PR |
Y | 103TC0700X | Clinical Psychologist | 4121 | PR |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0000X | Family Psychologist | ||
N | 103TF0000X | Family Psychologist | 4121 | PR |
N | 103TH0004X | Health Psychologist | ||
N | 103TH0004X | Health Psychologist | 4121 | PR |
N | 103TH0100X | Health Service | ||
N | 103TM1800X | Intellectual & Developmental Disabilities | ||
N | 103TP2701X | Group Psychotherapist | ||
N | 103TP2701X | Group Psychotherapist | 4121 | PR |
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1194001933 |
---|---|
Provider Name | Dr. Jessica Gomez Perales |
First Address | San Juan, PR 00907-1509 |
Second Address | San Juan, PR 00907-1509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2011 |
Last Update Date | 23/03/2018 |