Emmanuel Jose Pena Serrano, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

7224 Issued in PR

Practice address

Calle Georgetown, No. 1000
Apt. 2, University Gardens
San Juan, PR 00927

Phone

(787) 579-7120

NPI assigned

Aug 8, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1639806763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 10339",
            "city": "OROCOVIS",
            "state": "PR",
            "postal_code": "007209605",
            "telephone_number": "787-579-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE GEORGETOWN, NO. 1000",
            "address_2": "APT. 2, UNIVERSITY GARDENS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00927",
            "telephone_number": "787-579-7120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PR 177",
            "address_2": "Calle Francisco Sein",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "00927",
            "country_code": "US",
            "telephone_number": "787-763-3667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENA SERRANO",
        "first_name": "EMMANUEL",
        "middle_name": "JOSE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "7224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivelisse Pena Jimeno, MD
• Jennifer M Pena Moreira, M.D.
• Kathia M Pena Rios, PHD
• Alba Janice Pena Rivera, MSW
• Jorge L Pena Ruiz I, MD
• Jiovanni Eldrick Pena-Melendez, MSW
• Doris Margarita Pena
• Hector Omar Pena, DC
• Lorna M Pena, M.A.
• Luz Magali Pena, MD DERMATOLOGIST

• Clinical Psychologist in San Juan, PR
• Providers in San Juan, PR by specialty
• Clinical Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.