Provider Demographics
NPI:1548921380
Name:HERREJON, AZRREL ABET (APCC)
Entity type:Individual
Prefix:
First Name:AZRREL
Middle Name:ABET
Last Name:HERREJON
Suffix:
Gender:F
Credentials:APCC
Other - Prefix:
Other - First Name:AZRREL
Other - Middle Name:ABET
Other - Last Name:HERREJON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APCC
Mailing Address - Street 1:828 HIGH ST STE C
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-2960
Mailing Address - Country:US
Mailing Address - Phone:661-725-2788
Mailing Address - Fax:661-725-1957
Practice Address - Street 1:828 HIGH ST STE C
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-2960
Practice Address - Country:US
Practice Address - Phone:661-725-2788
Practice Address - Fax:661-725-1957
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC9479101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health