Provider Demographics
NPI:1225320120
Name:PEREZ, ROSANNA R (DC)
Entity Type:Individual
Prefix:DR
First Name:ROSANNA
Middle Name:R
Last Name:PEREZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2065 S ESCONDIDO BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-8221
Mailing Address - Country:US
Mailing Address - Phone:760-565-2225
Mailing Address - Fax:760-690-2212
Practice Address - Street 1:2065 S ESCONDIDO BLVD STE 105
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-8221
Practice Address - Country:US
Practice Address - Phone:760-565-2225
Practice Address - Fax:760-565-2225
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFM494AMedicaid