Provider Demographics
NPI:1467332387
Name:DEHERRERA, SYLVIA
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:DEHERRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 ONTARIO ST
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004-4253
Mailing Address - Country:US
Mailing Address - Phone:719-415-5280
Mailing Address - Fax:
Practice Address - Street 1:2721 ONTARIO ST
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-4253
Practice Address - Country:US
Practice Address - Phone:719-415-5280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician