Provider Demographics
NPI:1548502115
Name:PALLARES, PETE (MA, MS)
Entity type:Individual
Prefix:MR
First Name:PETE
Middle Name:
Last Name:PALLARES
Suffix:
Gender:M
Credentials:MA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 JERSEY ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-3808
Mailing Address - Country:US
Mailing Address - Phone:415-309-7981
Mailing Address - Fax:
Practice Address - Street 1:127 JERSEY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-3808
Practice Address - Country:US
Practice Address - Phone:415-309-7981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2015-05-01
Deactivation Date:2014-05-01
Deactivation Code:
Reactivation Date:2015-05-01
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health