Nereyda G Pederson, LPC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

19897 Issued in TX

Practice address

13330 Blanco Rd
#606
San Antonio, TX 78216-2193

Phone

(210) 882-8466

Fax

(210) 314-4449

NPI assigned

Jan 24, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1264291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264291200000",
    "number": "1811228281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 HUNTERS BRANCH S",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782311208",
            "telephone_number": "210-882-8466",
            "fax_number": "210-314-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13330 BLANCO RD",
            "address_2": "#606",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782162193",
            "telephone_number": "210-882-8466",
            "fax_number": "210-314-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "NEREYDA",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-24",
        "last_updated": "2010-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "19897",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "19897",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "TX",
            "license": "19897",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "19897",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annette Johanna Pedersen, LPC
• Craig Steven Pedersen, D.O.
• Jacqueline Pedersen, RDN, LD
• Karin Whitney Pedersen, AU.D.
• David N Pederson, MD
• Pedi Place at Westover Hills
• Pedi Spot LLC
• Pedia Pros Home Health, Inc.
• Pediatric Anesthesia Consultants of San Antonio PLLC
• Pediatric Dentistry of San Antonio

• Counseling Psychologist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Counseling Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2010; 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.