Jose Carlos Pena, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY13353 Issued in CA

Practice address

4550 Kearny Villa Rd
Suite 116
San Diego, CA 92123-1578

Phone

(858) 279-1223

Fax

(858) 279-6154

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003831082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 BANCROFT ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921045122",
            "telephone_number": "619-282-3822",
            "fax_number": "619-563-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 KEARNY VILLA RD",
            "address_2": "SUITE 116",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231578",
            "telephone_number": "858-279-1223",
            "fax_number": "858-279-6154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "JOSE",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita Pena, LVN
• Ann Marie Pena, MD
• Edwin Pena, PT, DPT
• Janet Guadalupe Pena
• Jocelyn Pena
• Justy Pena
• Kassandra Danelli Pena, CCC-SLP
• Mary Elizabeth Pena
• Nancy Fe Pena, LMFT
• Sandra Pena

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.