Provider Demographics
NPI:1740052646
Name:PEREIRA, AMBER DAWN
Entity type:Individual
Prefix:MS
First Name:AMBER
Middle Name:DAWN
Last Name:PEREIRA
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 1:3726 GRAYSTOKE WAY
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-5296
Mailing Address - Country:US
Mailing Address - Phone:559-375-1413
Mailing Address - Fax:
Practice Address - Street 1:3937 GRIFFITH AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93619-7264
Practice Address - Country:US
Practice Address - Phone:559-375-1314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor