Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicole M Fourquet, DRA

Individual provider Clinical Child & Adolescent Psychologist · NPI 1811851959

Nicole M Fourquet, DRA is a Clinical Psychologist in Ponce, Puerto Rico. Qualified in 2025, 1 year ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Puerto Rico.

Years since qualifying
1
Licensed in
PR
In the registry since
2025
Specialties on file
2
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Practice location Address may be wrong

The ZIP code does not match the city and state on this record. Call before visiting.

1123 Ave Hostos
Ponce, PR 00717-0952
Phone: (787) 637-1408

No coordinates on file. Search this address in Google Maps

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 8722 (PR)
Clinical Child & Adolescent Psychologist Taxonomy 103TC2200X · Licence 8722 (PR)

Record details

NPI number1811851959
Entity typeIndividual (Type 1)
GenderFemale
Credentials DRA
Sole proprietorYes
NPI enumeratedDecember 12, 2025
Last updated in NPPESDecember 12, 2025
Certification dateDecember 10, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Ponce