Provider Demographics
NPI:1730737354
Name:PEREIRA, MARIA LUIZA SOARES
Entity type:Individual
Prefix:
First Name:MARIA LUIZA
Middle Name:SOARES
Last Name:PEREIRA
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 1:22613 WOODRIDGE DR APT 31
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-3272
Mailing Address - Country:US
Mailing Address - Phone:510-343-4886
Mailing Address - Fax:
Practice Address - Street 1:22613 WOODRIDGE DR APT 31
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-3272
Practice Address - Country:US
Practice Address - Phone:510-343-4886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician