Provider Demographics
NPI:1417252115
Name:SAN PEDRO, MARIA AURORA ALMARIO
Entity Type:Individual
Prefix:
First Name:MARIA AURORA
Middle Name:ALMARIO
Last Name:SAN PEDRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA AURORA
Other - Middle Name:SICAT
Other - Last Name:ALMARIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 26733
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92196-0733
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17701 SAN PASQUAL VALLEY RD
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-5301
Practice Address - Country:US
Practice Address - Phone:760-741-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-11
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68542106H00000X
CA106101106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist