Provider Demographics
NPI:1548646573
Name:FIERRO, PAUL ROBERT JR (MA)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:ROBERT
Last Name:FIERRO
Suffix:JR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3204
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93942-3204
Mailing Address - Country:US
Mailing Address - Phone:831-268-6328
Mailing Address - Fax:
Practice Address - Street 1:109 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2629
Practice Address - Country:US
Practice Address - Phone:831-296-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106893106H00000X
CA88104106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist