Active NPI
Reina Juarez
- Psychologist
- La Jolla, CA
National Provider Identifier
1194083972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY8112
- Practice address
- University of California San Diego 0304
9500 Gilman Dr.
La Jolla, CA 92093-0304 - Phone
- (858) 534-3758
- Fax
- (858) 534-2628
- NPI assigned
- Apr 30, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY8112 | CA | Primary |
Addresses
Primary practice location
University of California San Diego 0304
9500 Gilman Dr.
La Jolla, CA 92093-0304
Mailing address
University of California San Diego 0304
9500 Gilman Dr.
La Jolla, CA 92093-0304
Phone (858) 534-3758
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY8112 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335744000000",
"number": "1194083972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "UNIVERSITY OF CALIFORNIA SAN DIEGO 0304",
"address_2": "9500 GILMAN DR.",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920930304",
"telephone_number": "858-534-3758",
"fax_number": "858-534-2628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "UNIVERSITY OF CALIFORNIA SAN DIEGO 0304",
"address_2": "9500 GILMAN DR.",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920930304",
"telephone_number": "858-534-3758",
"fax_number": "858-534-2628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUAREZ",
"first_name": "REINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-30",
"last_updated": "2012-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY8112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.