Provider Demographics
NPI:1962664771
Name:LERMA, AMBER FAITH (MD)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:FAITH
Last Name:LERMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ORINDA WAY
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2519
Mailing Address - Country:US
Mailing Address - Phone:925-900-5959
Mailing Address - Fax:419-408-6933
Practice Address - Street 1:8 ORINDA WAY
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2519
Practice Address - Country:US
Practice Address - Phone:925-900-5959
Practice Address - Fax:419-408-6933
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2364802084P0800X
CAA1258372084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1211951Medicaid