Provider Demographics
NPI:1891139119
Name:PELAEZ, JOHN F (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:F
Last Name:PELAEZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 3RD ST
Mailing Address - Street 2:STE. 201
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-0554
Mailing Address - Country:US
Mailing Address - Phone:707-441-8626
Mailing Address - Fax:707-442-5040
Practice Address - Street 1:930 3RD ST
Practice Address - Street 2:STE. 201
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-0554
Practice Address - Country:US
Practice Address - Phone:707-441-8626
Practice Address - Fax:707-442-5040
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 120361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical