Provider Demographics
NPI:1891183067
Name:PESQUEIRA, ANA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:PESQUEIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-2302
Mailing Address - Country:US
Mailing Address - Phone:442-265-1525
Mailing Address - Fax:442-265-1638
Practice Address - Street 1:202 N 8TH ST
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-2302
Practice Address - Country:US
Practice Address - Phone:442-265-1525
Practice Address - Fax:442-265-1638
Is Sole Proprietor?:No
Enumeration Date:2014-12-22
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 37327101Y00000X, 1041C0700X
CAASW37327104100000X
CALCSW89026104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical