MEDICARE: DR. JUDITH PATRICIA CEPEDA PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	33597	TX

General Provider Information

NPI Number	:	1346577228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDITH PATRICIA CEPEDA PSYD

Provider Business Mailing Address
First Line	:	2734 WONDERVIEW DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-2903
Country	:	US
Telephone Number	:	512-698-0489
Fax Number	:

Provider Business Practice Location Address
First Line	:	2734 WONDERVIEW DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-2903
Country	:	US
Telephone Number	:	512-698-0489
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2009
Last Update Date	:	06/22/2023

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