Provider Demographics
NPI:1598997504
Name:NAVARRO, VERONICA CONCEPCION (MS)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:CONCEPCION
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1584
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-6584
Mailing Address - Country:US
Mailing Address - Phone:650-228-6153
Mailing Address - Fax:
Practice Address - Street 1:80 EUREKA SQ STE 151
Practice Address - Street 2:
Practice Address - City:PACIFICA
Practice Address - State:CA
Practice Address - Zip Code:94044-2603
Practice Address - Country:US
Practice Address - Phone:650-228-6153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53219101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health