Provider Demographics
NPI:1699916668
Name:GALVEZ, CLEORA E (BA)
Entity type:Individual
Prefix:
First Name:CLEORA
Middle Name:E
Last Name:GALVEZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MRS
Other - First Name:SUE
Other - Middle Name:
Other - Last Name:GALVEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:801 EMPIRE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-5702
Mailing Address - Country:US
Mailing Address - Phone:707-425-5744
Mailing Address - Fax:707-425-5162
Practice Address - Street 1:801 EMPIRE ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-5702
Practice Address - Country:US
Practice Address - Phone:707-425-5744
Practice Address - Fax:707-425-5162
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-20
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)