Provider Demographics
NPI:1992961726
Name:HERRERA, JUDITH PICAZO
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:PICAZO
Last Name:HERRERA
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 1:379 FRANSCIONI ST
Mailing Address - Street 2:
Mailing Address - City:SOLEDAD
Mailing Address - State:CA
Mailing Address - Zip Code:93960-3461
Mailing Address - Country:US
Mailing Address - Phone:831-320-1931
Mailing Address - Fax:
Practice Address - Street 1:359 GABILAN DR
Practice Address - Street 2:
Practice Address - City:SOLEDAD
Practice Address - State:CA
Practice Address - Zip Code:93960-3550
Practice Address - Country:US
Practice Address - Phone:831-769-8740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51610106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist