Provider Demographics
NPI:1346418043
Name:PERKINS, CHARLES E
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:E
Last Name:PERKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 AERO CAMINO
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-3149
Mailing Address - Country:US
Mailing Address - Phone:805-961-9200
Mailing Address - Fax:
Practice Address - Street 1:137 AERO CAMINO
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-3149
Practice Address - Country:US
Practice Address - Phone:805-961-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health