Provider Demographics
NPI:1336734078
Name:PEREYRA, SERGIO BENJAMIN (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:SERGIO
Middle Name:BENJAMIN
Last Name:PEREYRA
Suffix:
Gender:M
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 W FALLBROOK AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-6191
Mailing Address - Country:US
Mailing Address - Phone:559-472-0501
Mailing Address - Fax:
Practice Address - Street 1:410 W FALLBROOK AVE STE 105
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-6191
Practice Address - Country:US
Practice Address - Phone:559-472-0501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA123021106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist