Provider Demographics
NPI:1598937252
Name:PEGUEROS, NOEMI
Entity type:Individual
Prefix:
First Name:NOEMI
Middle Name:
Last Name:PEGUEROS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BRANNAN ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4831
Mailing Address - Country:US
Mailing Address - Phone:415-864-4655
Mailing Address - Fax:415-626-2398
Practice Address - Street 1:1000 BRANNAN ST
Practice Address - Street 2:SUITE 401
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4831
Practice Address - Country:US
Practice Address - Phone:415-864-4655
Practice Address - Fax:415-626-2398
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No174400000XOther Service ProvidersSpecialist