Provider Demographics
NPI:1568588739
Name:TRINIDAD, PRISCILLA MESIAS
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:MESIAS
Last Name:TRINIDAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 SOUTH L. STREET
Mailing Address - Street 2:
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618
Mailing Address - Country:US
Mailing Address - Phone:559-591-6680
Mailing Address - Fax:
Practice Address - Street 1:144 SOUTH L. STREET
Practice Address - Street 2:
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618
Practice Address - Country:US
Practice Address - Phone:559-591-6680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional