Individual provider Active NPI

Gesenia S Sloan-Pena, MA

  • Clinical Neuropsychologist
  • Estero, FL
National Provider Identifier
1437380490
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Practice address
20301 Grande Oak Shoppes Blvd # 118-58
Estero, FL 33928-7698
Phone
(954) 803-9002
NPI assigned
Aug 7, 2009
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X
Clinical Neuropsychologist 103G00000X Primary

Addresses

Primary practice location

20301 Grande Oak Shoppes Blvd # 118-58
Estero, FL 33928-7698

Mailing address

20301 Grande Oak Shoppes Blvd # 118-58
Estero, FL 33928-7698

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)
Enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1437380490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20301 GRANDE OAK SHOPPES BLVD # 118-58",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339287698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20301 GRANDE OAK SHOPPES BLVD # 118-58",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339287698",
            "telephone_number": "954-803-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOAN-PENA",
        "first_name": "GESENIA",
        "middle_name": "S",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-07",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Estero, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.