Provider Demographics
NPI:1265040521
Name:PEREZ, KARLA YANELLI
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:YANELLI
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2436 E 4TH ST PMB 1017
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814
Mailing Address - Country:US
Mailing Address - Phone:562-544-4426
Mailing Address - Fax:
Practice Address - Street 1:5585 E PACIFIC COAST HWY UNIT 203
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-9467
Practice Address - Country:US
Practice Address - Phone:323-680-2935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
1146351041C0700X
CA1146351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health