Active NPI
Maria L Pena
- School Psychologist
- Omaha, NE
National Provider Identifier
1679154629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 12288
- Practice address
- 4519 S 24TH St
Omaha, NE 68107-1817 - Phone
- (531) 299-9298
- NPI assigned
- Apr 20, 2021
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 12288 | NE | Primary |
Addresses
Primary practice location
4519 S 24TH St
Omaha, NE 68107-1817
Mailing address
12905 Ohio Cir
Omaha, NE 68164-3470
Phone (531) 777-4950
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12288 | NE | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618876800000",
"number": "1679154629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12905 OHIO CIR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681643470",
"telephone_number": "531-777-4950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4519 S 24TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681071817",
"telephone_number": "531-299-9298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENA",
"first_name": "MARIA",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-20",
"last_updated": "2021-04-20",
"certification_date": "2021-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NE",
"license": "12288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.