MEDICARE: MRS. CARINA ESTHER DEVRIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1518151588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARINA ESTHER DEVRIES

Provider Business Mailing Address
First Line	:	2275 ARLINGTON DR
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94578-1132
Country	:	US
Telephone Number	:	510-317-1444
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 PANAMA ST
Second Line	:
City	:	HAYWARD
State	:	CA
Zip	:	94545-4662
Country	:	US
Telephone Number	:	925-603-7475
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2007
Last Update Date	:	08/07/2013

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