Provider Demographics
NPI:1740760297
Name:SANTOS, NERIVALDO CESAR (NERIVALDO)
Entity Type:Individual
Prefix:
First Name:NERIVALDO
Middle Name:CESAR
Last Name:SANTOS
Suffix:
Gender:M
Credentials:NERIVALDO
Other - Prefix:
Other - First Name:NERIVALDO
Other - Middle Name:
Other - Last Name:SANTOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:142 TRESTLE CV
Mailing Address - Street 2:
Mailing Address - City:HERCULES
Mailing Address - State:CA
Mailing Address - Zip Code:94547-2628
Mailing Address - Country:US
Mailing Address - Phone:510-508-7484
Mailing Address - Fax:
Practice Address - Street 1:1009B SOLANO AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-1617
Practice Address - Country:US
Practice Address - Phone:510-508-7484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist