Provider Demographics
NPI:1376143602
Name:CERA, DEBBIE ADRES
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:ADRES
Last Name:CERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4803 FUENTES WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-2811
Mailing Address - Country:US
Mailing Address - Phone:702-596-8475
Mailing Address - Fax:
Practice Address - Street 1:4803 FUENTES WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-2811
Practice Address - Country:US
Practice Address - Phone:702-596-8475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician