Provider Demographics
NPI:1568748929
Name:COVARRUBIAS, JAREKHYE ELIJAH
Entity Type:Individual
Prefix:MR
First Name:JAREKHYE
Middle Name:ELIJAH
Last Name:COVARRUBIAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10217 SAN PABLO AVENUE
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530
Mailing Address - Country:US
Mailing Address - Phone:510-559-1593
Mailing Address - Fax:
Practice Address - Street 1:10217 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-3111
Practice Address - Country:US
Practice Address - Phone:510-559-1593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker