Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 26725 | CA |
Y | 103TC0700X | Clinical Psychologist | 26725 | CA |
NPI | 1003210691 |
---|---|
Provider Name | Maria J Herrera |
First Address | Richmond, CA 94804-5239 |
Second Address | Fremont, CA 94538-5350 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2014 |
Last Update Date | 10/10/2014 |