Active NPI
Jordana Simone Pepper, PH.D
- Clinical Psychologist
- Aledo, TX
National Provider Identifier
1194584664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY.0006029
- Practice address
- 3701 Raven TRL Apt 1150
Aledo, TX 76008-2162 - Phone
- (760) 333-6577
- NPI assigned
- Mar 18, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY.0006029 | CO | Primary |
Addresses
Primary practice location
3701 Raven TRL Apt 1150
Aledo, TX 76008-2162
Mailing address
3701 Raven TRL Apt 1150
Aledo, TX 76008-2162
Phone (760) 333-6577
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY.0006029 | CO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710720000000",
"number": "1194584664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3701 RAVEN TRL APT 1150",
"city": "ALEDO",
"state": "TX",
"postal_code": "760082162",
"telephone_number": "760-333-6577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 RAVEN TRL APT 1150",
"city": "ALEDO",
"state": "TX",
"postal_code": "760082162",
"telephone_number": "760-333-6577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEPPER",
"first_name": "JORDANA",
"middle_name": "SIMONE",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-18",
"last_updated": "2024-03-18",
"certification_date": "2024-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "PSY.0006029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aledo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.