Provider Demographics
NPI:1922243989
Name:VIERA, LARRY E VII
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:E
Last Name:VIERA
Suffix:VII
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 PIONEER ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-2133
Mailing Address - Country:US
Mailing Address - Phone:831-476-4184
Mailing Address - Fax:831-476-0345
Practice Address - Street 1:3035 PRATHER LN
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1801
Practice Address - Country:US
Practice Address - Phone:831-476-4184
Practice Address - Fax:831-476-0345
Is Sole Proprietor?:No
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health