Healthcare Provider Details

I. General information

NPI: 1619757663
Provider Name (Legal Business Name): MARIA EUGENIA TIJERINO-LEW MSW, ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA EUGENIA TIJERINO MORALES

II. Dates (important events)

Enumeration Date: 10/05/2023
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24301 SOUTHLAND DR STE 300
HAYWARD CA
94545-1546
US

IV. Provider business mailing address

24301 SOUTHLAND DR STE 300
HAYWARD CA
94545-1546
US

V. Phone/Fax

Practice location:
  • Phone: 510-931-9962
  • Fax:
Mailing address:
  • Phone: 510-931-9962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number118401
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: