Provider Demographics
NPI:1780746040
Name:MORA-BYERS, BELEN (PSYD)
Entity type:Individual
Prefix:
First Name:BELEN
Middle Name:
Last Name:MORA-BYERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 EL CAMINO REAL
Mailing Address - Street 2:KAISER PERMANENTE CHILD PSYCHIATRY
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080
Mailing Address - Country:US
Mailing Address - Phone:650-742-3933
Mailing Address - Fax:650-742-7135
Practice Address - Street 1:1200 EL CAMINO REAL
Practice Address - Street 2:KAISER PERMANENTE CHILD PSYCHIATRY
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080
Practice Address - Country:US
Practice Address - Phone:650-742-3933
Practice Address - Fax:650-742-7135
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 17818103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical