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General NPI Number Information
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NPI Number | 1588535637
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Entity Type | Individual
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Provider Name | RICARDO HEREDIA PPS
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Gender | Male
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Dates
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Enumeration Date | 09/12/2025
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 3400 NICOLET AVE
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City | FREMONT
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State | CA
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Zip | 94536-3536
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Country | US
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Telephone | 510-797-5940
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Fax |
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Provider Business Mailing Address
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Address Line | 4210 TECHNOLOGY DR
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City | FREMONT
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State | CA
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Zip | 94538-6337
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Country | US
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Telephone | 510-657-2350
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 250178932
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License Number State | CA
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