Provider Demographics
NPI:1437891207
Name:VERANO, MAE-RICHELLE RAGASA (MSW)
Entity Type:Individual
Prefix:
First Name:MAE-RICHELLE
Middle Name:RAGASA
Last Name:VERANO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MAE
Other - Middle Name:
Other - Last Name:VERANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:160 E VIRGINIA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-5865
Mailing Address - Country:US
Mailing Address - Phone:408-938-2113
Mailing Address - Fax:408-579-6143
Practice Address - Street 1:160 E VIRGINIA ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-5865
Practice Address - Country:US
Practice Address - Phone:408-938-2113
Practice Address - Fax:408-579-6143
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2023-09-06
Deactivation Date:2023-07-06
Deactivation Code:
Reactivation Date:2023-07-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program