Provider Demographics
NPI:1770052029
Name:SUAREZ, VIRGINIA A (PSYD)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:A
Last Name:SUAREZ
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 MARIA LN STE 300
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5314
Mailing Address - Country:US
Mailing Address - Phone:408-596-9469
Mailing Address - Fax:
Practice Address - Street 1:1460 MARIA LN STE 300
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5314
Practice Address - Country:US
Practice Address - Phone:925-385-8228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94028040103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical