Provider Demographics
NPI:1538664669
Name:PEI, TRIXIE LORRAINE CRUZ (MD)
Entity Type:Individual
Prefix:
First Name:TRIXIE LORRAINE
Middle Name:CRUZ
Last Name:PEI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TRIXIE LORRAINE
Other - Middle Name:CENDANA
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3230 BEARD RD STE 1
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3659
Mailing Address - Country:US
Mailing Address - Phone:707-253-7005
Mailing Address - Fax:707-253-7271
Practice Address - Street 1:3230 BEARD RD STE 2537005
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3673
Practice Address - Country:US
Practice Address - Phone:707-253-7005
Practice Address - Fax:707-253-7271
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA184644207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program