Active NPI
Jennifer Heretick Massa, PH.D.
- Psychologist
- St Petersburg, FL
National Provider Identifier
1790120186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY8899
- Practice address
- 401 Pasadena Ave S
St Petersburg, FL 33707-2101 - Phone
- (727) 386-8231
- NPI assigned
- Apr 30, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY8899 | FL | Primary |
Addresses
Primary practice location
401 Pasadena Ave S
St Petersburg, FL 33707-2101
Mailing address
401 Pasadena Ave S
St Petersburg, FL 33707-2101
Phone (727) 386-8231
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
| License | State | Type | Specialty |
|---|---|---|---|
| PY8899 | FL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384732800000",
"number": "1790120186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 PASADENA AVE S",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337072101",
"telephone_number": "727-386-8231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 PASADENA AVE S",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337072101",
"telephone_number": "727-386-8231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASSA",
"first_name": "JENNIFER",
"middle_name": "HERETICK",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-30",
"last_updated": "2013-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY8899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.