Active NPI
Ray Pena Leuterio, PH D
- Psychologist
- Tuba City, AZ
National Provider Identifier
1356630362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4041953
- Practice address
- 67 Fir St
Tuba City, AZ 86045-0067 - Phone
- (928) 283-1161
- Fax
- (928) 283-1205
- NPI assigned
- Mar 30, 2011
- Sex
- Male
- 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 | 4041953 | AZ | Primary |
Addresses
Primary practice location
67 Fir St
Tuba City, AZ 86045-0067
Mailing address
PO Box 1169
Tuba City, AZ 86045-1169
Phone (928) 283-1057
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 |
|---|---|---|---|
| 4041953 | AZ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304553600000",
"number": "1356630362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1169",
"city": "TUBA CITY",
"state": "AZ",
"postal_code": "860451169",
"telephone_number": "928-283-1057",
"fax_number": "928-283-1205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 FIR ST",
"city": "TUBA CITY",
"state": "AZ",
"postal_code": "860450067",
"telephone_number": "928-283-1161",
"fax_number": "928-283-1205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEUTERIO",
"first_name": "RAY",
"middle_name": "PENA",
"name_prefix": "Dr.",
"credential": "PH D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-03-30",
"last_updated": "2011-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AZ",
"license": "4041953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tuba City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.