Provider Demographics
NPI:1184233637
Name:CORTEZ-MCLAUGHLIN, PEDRO ADRIAN
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:ADRIAN
Last Name:CORTEZ-MCLAUGHLIN
Suffix:
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 1:1561 GORDON ST APT A
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-2830
Mailing Address - Country:US
Mailing Address - Phone:650-308-5214
Mailing Address - Fax:
Practice Address - Street 1:647 VETERANS BLVD STE A
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1441
Practice Address - Country:US
Practice Address - Phone:650-336-0054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA135923106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health