Provider Demographics
NPI:1205271988
Name:PENARANDA, VANESSA GRACE PANIZALES (MD)
Entity type:Individual
Prefix:DR
First Name:VANESSA GRACE
Middle Name:PANIZALES
Last Name:PENARANDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VANESSA GRACE
Other - Middle Name:LAGON
Other - Last Name:PANIZALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3102 HAINE DR
Mailing Address - Street 2:APT 927
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550
Mailing Address - Country:US
Mailing Address - Phone:281-824-5182
Mailing Address - Fax:
Practice Address - Street 1:6605 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1000
Practice Address - Country:US
Practice Address - Phone:419-841-7701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1491882084P0800X
TXR27042084P0800X
OH35.1274762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry