Provider Demographics
NPI:1437273489
Name:PEREZ, PERLA IVETTE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PERLA
Middle Name:IVETTE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:PERLA
Other - Middle Name:I
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:2140 MERCED ST STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1721
Mailing Address - Country:US
Mailing Address - Phone:831-214-4825
Mailing Address - Fax:
Practice Address - Street 1:1270 NATIVIDAD RD RM 200
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3122
Practice Address - Country:US
Practice Address - Phone:831-755-4510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA295161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical