Provider Demographics
NPI:1255859724
Name:PEREZ, ANGELICA (NP)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15725 WHITTIER BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-2350
Mailing Address - Country:US
Mailing Address - Phone:562-947-3307
Mailing Address - Fax:562-906-5541
Practice Address - Street 1:15725 WHITTIER BLVD STE 500
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2350
Practice Address - Country:US
Practice Address - Phone:562-947-3307
Practice Address - Fax:562-906-5541
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95006387363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology