Individual provider Active NPI

Josephine Vasquez Serrata, PH.D.

  • Clinical Psychologist
  • Austin, TX
National Provider Identifier
1760977755
Registry record updated Jun 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
37018 Issued in TX
Practice address
4422 Pack Saddle Pass Ste 102
Austin, TX 78745-1644
Phone
(512) 956-9420
Fax
(512) 870-9772
NPI assigned
Jun 22, 2018
Last updated
Jun 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 37018 TX Primary

Addresses

Primary practice location

4422 Pack Saddle Pass Ste 102
Austin, TX 78745-1644

Mailing address

4422 Pack Saddle Pass Ste 102
Austin, TX 78745-1644
Phone (512) 956-9420

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
37018TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Serrata and Hurtado, Inc. Clinical Current Accepting new patients

Locations

4422 Pack Saddle Pass
Ste 102
Austin, TX 78745
Phone (512) 566-4528

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1760977755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 PACK SADDLE PASS STE 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451644",
            "telephone_number": "512-956-9420",
            "fax_number": "512-870-9772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 PACK SADDLE PASS STE 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451644",
            "telephone_number": "512-956-9420",
            "fax_number": "512-870-9772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRATA",
        "first_name": "JOSEPHINE",
        "middle_name": "VASQUEZ",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; 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.