1750747614 NPI number — RAYMOND FIERRO MA COUNSELING IN EDU

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750747614 NPI number — RAYMOND FIERRO MA COUNSELING IN EDU

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FIERRO
Provider First Name:
RAYMOND
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA COUNSELING IN EDU
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750747614
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1936 CAMDEN AVE STE 5A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95124-2845
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
669-300-6946
Provider Business Mailing Address Fax Number:
669-300-6936

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1790 HAMILTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95125-5424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-377-0377
Provider Business Practice Location Address Fax Number:
408-377-0373
Provider Enumeration Date:
01/07/2016

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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