Provider Demographics
NPI:1245602523
Name:NAJERA, FLORA LORETO (MA, PCCI)
Entity Type:Individual
Prefix:
First Name:FLORA
Middle Name:LORETO
Last Name:NAJERA
Suffix:
Gender:F
Credentials:MA, PCCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2342 CORTE MADURO UNIT 117
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-5012
Mailing Address - Country:US
Mailing Address - Phone:619-261-8048
Mailing Address - Fax:
Practice Address - Street 1:1105 BROADWAY STE 207
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-2767
Practice Address - Country:US
Practice Address - Phone:619-425-5609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPCCI718101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health