Provider Demographics
NPI:1053112367
Name:BAQUERO, PIERRE A
Entity type:Individual
Prefix:
First Name:PIERRE
Middle Name:A
Last Name:BAQUERO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39198 HALF MOON CIR
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-2823
Mailing Address - Country:US
Mailing Address - Phone:909-938-4785
Mailing Address - Fax:
Practice Address - Street 1:41760 IVY ST STE 102
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-9416
Practice Address - Country:US
Practice Address - Phone:951-215-6253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-22
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician