Healthcare Provider Details

I. General information

NPI: 1801349592
Provider Name (Legal Business Name): ANN HERRERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE HERRERA

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3377 RIVERBEND DR
SPRINGFIELD OR
97477-8803
US

IV. Provider business mailing address

1170 PEARL ST
EUGENE OR
97401-3541
US

V. Phone/Fax

Practice location:
  • Phone: 541-222-6160
  • Fax: 541-222-6166
Mailing address:
  • Phone: 541-743-4340
  • Fax: 541-743-4369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL11275
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: