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General NPI Number Information
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NPI Number | 1093229585
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Entity Type | Individual
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Provider Name | ADRIAN DE VERA
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Gender | Male
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Dates
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Enumeration Date | 11/20/2017
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 625 FAIR OAKS AVE
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-2630
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Country | US
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Telephone | 626-802-7130
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Fax |
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Provider Business Mailing Address
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Address Line | 3709 LEGATO CT
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City | POMONA
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State | CA
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Zip | 91766-0982
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State | CA
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