Provider Demographics
NPI:1578759312
Name:MERAZ, GUADALUPE FELIX
Entity Type:Individual
Prefix:MRS
First Name:GUADALUPE
Middle Name:FELIX
Last Name:MERAZ
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 1:84210 MIRAMAR COURT
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236
Mailing Address - Country:US
Mailing Address - Phone:760-391-5639
Mailing Address - Fax:
Practice Address - Street 1:68625 PEREZ RD
Practice Address - Street 2:SUITE #11A
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-7250
Practice Address - Country:US
Practice Address - Phone:760-773-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator