Provider Demographics
NPI:1184695181
Name:MIYARES-PIPER, MARIA HERNANDEZ (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:HERNANDEZ
Last Name:MIYARES-PIPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 E LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-4617
Mailing Address - Country:US
Mailing Address - Phone:619-687-4209
Mailing Address - Fax:619-441-2821
Practice Address - Street 1:615 E LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-4617
Practice Address - Country:US
Practice Address - Phone:619-687-4209
Practice Address - Fax:619-441-2821
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA154061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA235925OtherTRICARE
CACSW154060Medicaid
CASW15406Medicare ID - Type Unspecified