Provider Demographics
NPI:1598051393
Name:NUNEZ, LIBRADO ELOY (SNR CHWS)
Entity Type:Individual
Prefix:
First Name:LIBRADO
Middle Name:ELOY
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:SNR CHWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2044
Mailing Address - Country:US
Mailing Address - Phone:510-981-5391
Mailing Address - Fax:510-981-5358
Practice Address - Street 1:830 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-2044
Practice Address - Country:US
Practice Address - Phone:510-981-5391
Practice Address - Fax:510-981-5358
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor