Provider Demographics
NPI:1497927990
Name:PEREZ, JANAE (CPHT)
Entity Type:Individual
Prefix:MS
First Name:JANAE
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 HOWARD STREET
Mailing Address - Street 2:ROOM 130
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2638
Mailing Address - Country:US
Mailing Address - Phone:415-255-3659
Mailing Address - Fax:415-255-3754
Practice Address - Street 1:1380 HOWARD STREET
Practice Address - Street 2:ROOM 130
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2638
Practice Address - Country:US
Practice Address - Phone:415-255-3659
Practice Address - Fax:415-255-3754
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATCH10376183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician