Provider Demographics
NPI:1356804157
Name:AMBER LERMA, MD, PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:AMBER LERMA, MD, PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, PRESIDENT, SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:FAITH
Authorized Official - Last Name:LERMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-771-0728
Mailing Address - Street 1:68 GAYWOOD PL
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556-1716
Mailing Address - Country:US
Mailing Address - Phone:925-771-0728
Mailing Address - Fax:
Practice Address - Street 1:37 AVENIDA DE ORINDA
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2305
Practice Address - Country:US
Practice Address - Phone:925-900-5959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty