Provider Demographics
NPI:1497186696
Name:PEREZ, LAURA (CPM, LM)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 BRUNSWICK ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-4434
Mailing Address - Country:US
Mailing Address - Phone:415-586-4805
Mailing Address - Fax:
Practice Address - Street 1:35 BRUNSWICK ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-4434
Practice Address - Country:US
Practice Address - Phone:415-846-8950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM377176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife