Provider Demographics
NPI:1598580128
Name:SERRANO, JUDAH WARREN (PHD)
Entity type:Individual
Prefix:DR
First Name:JUDAH
Middle Name:WARREN
Last Name:SERRANO
Suffix:
Gender:X
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9360 E 60TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2347
Mailing Address - Country:US
Mailing Address - Phone:307-630-9391
Mailing Address - Fax:
Practice Address - Street 1:9360 E 60TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-2347
Practice Address - Country:US
Practice Address - Phone:307-630-9391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006607103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent