Provider Demographics
NPI:1427469279
Name:PEDRAZA, EVERARDO (MS)
Entity type:Individual
Prefix:MR
First Name:EVERARDO
Middle Name:
Last Name:PEDRAZA
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2243 S BUNDY DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-6555
Mailing Address - Country:US
Mailing Address - Phone:559-230-9736
Mailing Address - Fax:
Practice Address - Street 1:255 N FULTON ST STE 105
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-1600
Practice Address - Country:US
Practice Address - Phone:559-230-9736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist