Provider Demographics
NPI:1518146794
Name:PEREZ, PAULO ALEXANDRO (BA)
Entity Type:Individual
Prefix:MR
First Name:PAULO
Middle Name:ALEXANDRO
Last Name:PEREZ
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 D ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-6017
Mailing Address - Country:US
Mailing Address - Phone:530-671-3427
Mailing Address - Fax:
Practice Address - Street 1:103 D ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-6017
Practice Address - Country:US
Practice Address - Phone:530-671-3427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor