Provider Demographics
NPI:1558670356
Name:PEREIDA-ADAMS, DELIA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:DELIA
Middle Name:
Last Name:PEREIDA-ADAMS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1490 PARIS WAY
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-6050
Mailing Address - Country:US
Mailing Address - Phone:925-371-0579
Mailing Address - Fax:
Practice Address - Street 1:1490 PARIS WAY
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-6050
Practice Address - Country:US
Practice Address - Phone:925-371-0579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6405225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist