Jaisselle Marie Vega Rosaly, PHD
NPI 1104379320ActiveIndividual· Psychologist, Cognitive & Behavioral· Ponce, PR
Psychologist, Cognitive & Behavioral (PHD) in Ponce, Puerto Rico, licensed in PR, with an NPI issued in July 2016. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1104379320 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | No |
| NPI issued | Jul 25, 2016 |
| Last updated in NPPES | Jul 25, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Cognitive & Behavioral Primary | 103TB0200X | 5738 | PR |
| Psychologist, Clinical | 103TC0700X | 5738 | PR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (PR) |
|---|
Education and affiliations
| Graduation year | 2013 |
|---|---|
| Medicare specialty | Clinical Psychologist |
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