Healthcare Provider Details

I. General information

NPI: 1467550533
Provider Name (Legal Business Name): MONIQUE JIMENEZ PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA SUCHVILLE, CARRETERA #2 SUITE 202
GUAYNABO PR
00966
US

IV. Provider business mailing address

2130 CALLE LERNA ALTO APOLO
GUAYNABO PR
00969-4937
US

V. Phone/Fax

Practice location:
  • Phone: 787-994-8242
  • Fax:
Mailing address:
  • Phone: 787-994-8242
  • Fax: 787-789-8458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2485
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number2485
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2485
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: