Provider Demographics
NPI:1639370240
Name:VERMAZEN, MARIA RENEE (BA CAS)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:RENEE
Last Name:VERMAZEN
Suffix:
Gender:F
Credentials:BA CAS
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Other - Credentials:
Mailing Address - Street 1:1271 WASHINGTON AVE PMB -176
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-3646
Mailing Address - Country:US
Mailing Address - Phone:510-614-1097
Mailing Address - Fax:
Practice Address - Street 1:795 FLETCHER LN
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-1008
Practice Address - Country:US
Practice Address - Phone:510-247-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)