Organization Active NPI

Cerebella LLC

  • Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1528616935
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
CEREBELLA LLC
Practice address
16019 Via Shavano
San Antonio, TX 78249-2370
Phone
(210) 696-9292
Fax
(210) 690-8815
NPI assigned
Aug 28, 2019
Last updated
Aug 28, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Authorized official

Name
Deborah Trevino
Title
Receptionist/Admin
Phone
(210) 696-9292

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

16019 Via Shavano
San Antonio, TX 78249-2370

Mailing address

16019 Via Shavano
San Antonio, TX 78249-2370
Phone (210) 696-9292

National Provider Directory

National Provider Directory

Locations

16019 Via Shavano
San Antonio, TX 78249
Phone (210) 393-4598

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566950400000",
    "number": "1528616935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16019 VIA SHAVANO",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492370",
            "telephone_number": "210-696-9292",
            "fax_number": "210-690-8815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16019 VIA SHAVANO",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492370",
            "telephone_number": "210-696-9292",
            "fax_number": "210-690-8815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEREBELLA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-28",
        "last_updated": "2019-08-28",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "RECEPTIONIST/ADMIN",
        "authorized_official_telephone_number": "210-696-9292"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.