Provider Demographics
NPI:1861241531
Name:PEART, CIERA SHAYNE
Entity type:Individual
Prefix:
First Name:CIERA
Middle Name:SHAYNE
Last Name:PEART
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 1:14751 N 141ST LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-8719
Mailing Address - Country:US
Mailing Address - Phone:858-395-0460
Mailing Address - Fax:
Practice Address - Street 1:14751 N 141ST LN
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-8719
Practice Address - Country:US
Practice Address - Phone:858-395-0460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician