Provider Demographics
NPI:1437302072
Name:PEREZ, ERICKA ELIZABETH (RAS)
Entity Type:Individual
Prefix:MS
First Name:ERICKA
Middle Name:ELIZABETH
Last Name:PEREZ
Suffix:
Gender:F
Credentials:RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-4047
Mailing Address - Country:US
Mailing Address - Phone:650-701-4619
Mailing Address - Fax:650-573-2841
Practice Address - Street 1:400 HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-4047
Practice Address - Country:US
Practice Address - Phone:650-701-4619
Practice Address - Fax:650-573-2841
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR0810222130101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health