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General NPI Number Information
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NPI Number | 1306323985
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Entity Type | Organization
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Legal Business Name | SERRATA AND HURTADO, INC.
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Dates
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Enumeration Date | 07/25/2018
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Last Update Date | 07/25/2018
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Provider Practice Location Address
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Address Line | 4422 PACK SADDLE PASS STE 102
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City | AUSTIN
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State | TX
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Zip | 78745-1644
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Country | US
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Telephone | 512-956-9420
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Fax | 512-870-9772
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Provider Business Mailing Address
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Address Line | 4422 PACK SADDLE PASS STE 102
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City | AUSTIN
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State | TX
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Zip | 78745-1644
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Country | US
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Telephone | 512-956-9420
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Fax | 512-870-9772
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Authorized Official
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Title or Position | OWNER/LICENSED PSYCHOLOGIST
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Name | DR. JOSEPHINE VASQUEZ SERRATA
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Credential | PH.D.
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Telephone | 210-326-9185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 37018
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License Number State | TX
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