Provider Demographics
NPI:1124594692
Name:BEM, MARIA DE FATIMA DA ROSA
Entity Type:Individual
Prefix:
First Name:MARIA DE FATIMA
Middle Name:DA ROSA
Last Name:BEM
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 1:249 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5383
Mailing Address - Country:US
Mailing Address - Phone:510-230-6563
Mailing Address - Fax:
Practice Address - Street 1:410 E 7TH ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4606
Practice Address - Country:US
Practice Address - Phone:559-584-8100
Practice Address - Fax:559-585-2008
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)