Healthcare Provider Details

I. General information

NPI: 1174009161
Provider Name (Legal Business Name): JENNIFER M SERRANO RIOS PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2018
Last Update Date: 12/31/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 EDIFICIO SANTA CRUZ CALLE SANTA CRUZ SUITE 303
BAYAMON PR
00961-6919
US

IV. Provider business mailing address

361 CALLE TOPACIO MANSIONES DEL CARIBE
HUMACAO PR
00791
US

V. Phone/Fax

Practice location:
  • Phone: 787-590-9911
  • Fax:
Mailing address:
  • Phone: 787-940-1480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number006165
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: