Jennifer E Medina PHD PC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY.0004192 Issued in CO

Legal business name

JENNIFER E MEDINA PHD PC

Practice address

4045 Pecos St Ste 150
Denver, CO 80211-2561

Phone

(720) 295-0357

NPI assigned

Oct 21, 2014

Last updated

Nov 20, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Medina, PHD

Title

Owner

Phone

(720) 295-0357

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1649674524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 PECOS ST STE 150",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802112561",
            "telephone_number": "720-295-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 PECOS ST STE 150",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802112561",
            "telephone_number": "720-295-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER E MEDINA PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-21",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-295-0357",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CO",
            "license": "PSY.0004192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Denver, CO
• Providers in Denver, CO by specialty
• Clinical Neuropsychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.