Provider Demographics
NPI:1013571777
Name:PEREZ, ESMERALDA (RN,PHN)
Entity Type:Individual
Prefix:MRS
First Name:ESMERALDA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:RN,PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 ACTIS RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-5911
Mailing Address - Country:US
Mailing Address - Phone:661-831-1906
Mailing Address - Fax:661-831-8256
Practice Address - Street 1:4200 ASHE RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-2029
Practice Address - Country:US
Practice Address - Phone:661-831-8331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA801887163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool