1366671885 NPI number — MRS. IRMA VICTORIA CONTRERAS LCSW

Table of content: MRS. IRMA VICTORIA CONTRERAS LCSW (NPI 1366671885)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366671885 NPI number — MRS. IRMA VICTORIA CONTRERAS LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CONTRERAS
Provider First Name:
IRMA
Provider Middle Name:
VICTORIA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CONTRERAS
Provider Other First Name:
VICKY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1366671885
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/06/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9414 ARBOIS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78254-5820
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-413-6041
Provider Business Mailing Address Fax Number:
210-949-2047

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9414 ARBOIS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78254-5820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-413-6041
Provider Business Practice Location Address Fax Number:
210-949-2047
Provider Enumeration Date:
07/06/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  03706 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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