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Individual
ERIC DEREZA
Active
Individual
ERIC DEREZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
88623
CA
225400000X
Rehabilitation Practitioner
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/26/2013
Last updated
11/05/2019
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