Provider Demographics
NPI:1386693208
Name:NERIA, PIA (PA)
Entity type:Individual
Prefix:MS
First Name:PIA
Middle Name:
Last Name:NERIA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:801 S CHEVY CHASE DR
Mailing Address - Street 2:#20
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-4431
Mailing Address - Country:US
Mailing Address - Phone:818-265-2237
Mailing Address - Fax:818-265-2228
Practice Address - Street 1:801 S CHEVY CHASE DR
Practice Address - Street 2:#105
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-4431
Practice Address - Country:US
Practice Address - Phone:818-242-5299
Practice Address - Fax:818-637-7607
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA14176363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ01220Medicare UPIN