Provider Demographics
NPI:1346929890
Name:URENO, PETER ALEXANDER
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:ALEXANDER
Last Name:URENO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24706 TIOGA RD
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-2013
Mailing Address - Country:US
Mailing Address - Phone:510-940-5605
Mailing Address - Fax:
Practice Address - Street 1:39510 PASEO PADRE PKWY STE 190
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-4716
Practice Address - Country:US
Practice Address - Phone:510-403-5916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician