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General NPI Number Information
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NPI Number | 1457840282
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Entity Type | Individual
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Provider Name | ADRIANA PATRICIA PEREA
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Gender | Female
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 1249 PINOLE VALLEY RD STE 201
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City | PINOLE
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State | CA
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Zip | 94564-1383
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Country | US
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Telephone | 510-665-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 2227 W AVENUE 136TH APT B
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City | SAN LEANDRO
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State | CA
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Zip | 94577-4154
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Country | US
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Telephone | 510-514-6837
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-22-60679
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License Number State | CA
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