Provider Demographics
NPI:1760516173
Name:PEREYRA, GLORIA AHTZIRI (LCSW)
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:AHTZIRI
Last Name:PEREYRA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GLORIA
Other - Middle Name:
Other - Last Name:PEREYRA-SALAZAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW-ASW
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1000
Mailing Address - Country:US
Mailing Address - Phone:661-868-1850
Mailing Address - Fax:
Practice Address - Street 1:2525 N CHESTER AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-1770
Practice Address - Country:US
Practice Address - Phone:661-868-1850
Practice Address - Fax:661-868-1841
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA762731041C0700X
CA341691041C0700X
CA207921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical