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: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DOCTOR'S MEDICAL PAVILLION, SUITE 20 1394 CALLE SAN RAFAEL
SAN JUAN PR
00909-2525
US

IV. Provider business mailing address

MANSIONES DEL CARIBE 361 CALLE TOPACIO
HUMACAO PR
00791-5233
US

V. Phone/Fax

Practice location:
  • Phone: 787-530-9911
  • 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: