Provider Demographics
NPI:1093471138
Name:PEA, ERIA GELENA
Entity Type:Individual
Prefix:
First Name:ERIA
Middle Name:GELENA
Last Name:PEA
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 1:2450 SENTER RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95111-1053
Mailing Address - Country:US
Mailing Address - Phone:510-754-4600
Mailing Address - Fax:
Practice Address - Street 1:2450 SENTER RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95111-1053
Practice Address - Country:US
Practice Address - Phone:510-754-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist