Provider Demographics
NPI:1811673171
Name:MERRICK, CERA (FAE, SHE, CH)
Entity type:Individual
Prefix:
First Name:CERA
Middle Name:
Last Name:MERRICK
Suffix:
Gender:F
Credentials:FAE, SHE, CH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 GRAND AVE # 378
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4840
Mailing Address - Country:US
Mailing Address - Phone:510-560-5703
Mailing Address - Fax:
Practice Address - Street 1:559 32ND ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804-1531
Practice Address - Country:US
Practice Address - Phone:702-335-5390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor