Provider Demographics
NPI:1619757663
Name:TIJERINO-LEW, MARIA EUGENIA (MSW, ACSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA EUGENIA
Middle Name:
Last Name:TIJERINO-LEW
Suffix:
Gender:F
Credentials:MSW, ACSW
Other - Prefix:
Other - First Name:MARIA EUGENIA
Other - Middle Name:
Other - Last Name:TIJERINO MORALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24301 SOUTHLAND DR STE 300
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-1546
Mailing Address - Country:US
Mailing Address - Phone:510-931-9962
Mailing Address - Fax:
Practice Address - Street 1:24301 SOUTHLAND DR STE 300
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-1546
Practice Address - Country:US
Practice Address - Phone:510-931-9962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA118401390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program