Active NPI
Cristina Isabel Minana Perez, M.S., PSY.D.
- Clinical Psychologist
- San Bernardino, CA
National Provider Identifier
1609390475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY32637
- Practice address
- 780 E Gilbert St
San Bernardino, CA 92415-1003 - Phone
- (909) 387-7194
- NPI assigned
- Aug 2, 2017
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY32637 | CA | Primary |
Addresses
Primary practice location
780 E Gilbert St
San Bernardino, CA 92415-1003
Mailing address
780 E Gilbert St
San Bernardino, CA 92415-1003
Phone (909) 387-7194
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | DBH-GBH-D240193 | Health Information Exchange (HIE) |
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY32637 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pasadena Clinical Group, a Psychology Corporation | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1609390475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "780 E GILBERT ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924151003",
"telephone_number": "909-387-7194",
"fax_number": "909-387-7100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "780 E GILBERT ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924151003",
"telephone_number": "909-387-7194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINANA PEREZ",
"first_name": "CRISTINA",
"middle_name": "ISABEL",
"credential": "M.S., PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-02",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY32637",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "DBH-GBH-D240193",
"affiliation": "N",
"endpointDescription": "Encrypted Data",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "NA",
"address_1": "780 E Gilbert St",
"city": "San Bernardino",
"state": "CA",
"country_code": "US",
"postal_code": "924151003",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.