Most Relevant Information
Provider Data
| NPI Number: | 1003831082 |
| Provider Name: | JOSE CARLOS PENA PH.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC0700X |
| Specialty: | Psychologist |
| License Number: | PSY13353 |
Most Important Dates
| Enumeration Date: | 07/12/2006 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
4550 KEARNY VILLA RD
SUITE 116
SAN DIEGO
CA
921231578
Practice Location Phone/Fax
| Phone: | 8582791223 |
| Fax: | 8582796154 |
Provider Mailing Location
2418 BANCROFT ST
SAN DIEGO
CA
921045122
Provider Mailing Phone/Fax
| Phone: | 6192823822 |
| Fax: | 6195633913 |