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NPI Code Detail

MEDICARE: MR. RICARDO EUGENIO HERNANDEZ-PEREIRA BSW

MEDICARE: MR. RICARDO EUGENIO HERNANDEZ-PEREIRA BSW
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
1101YM0800XMental Health Counselor
2103K00000XBehavior Analyst
3104100000XSocial Worker

General Provider Information

NPI Number : 1891069480
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICARDO EUGENIO HERNANDEZ-PEREIRA BSW
Provider Business Mailing Address
First Line : 1624 SANTA CLARA DR STE 145
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-3500
Country : US
Telephone Number : 775-843-7418
Fax Number :
Provider Business Practice Location Address
First Line : 1624 SANTA CLARA DR STE 145
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-3500
Country : US
Telephone Number : 775-843-7418
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/29/2012
Last Update Date : 11/07/2022

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