Provider Demographics
NPI:1578648051
Name:PEREZ, SONIA PATRICIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:PATRICIA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:PATRICIA
Other - Last Name:PADILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1618 EDGEWATER LN
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6011
Mailing Address - Country:US
Mailing Address - Phone:323-449-6114
Mailing Address - Fax:
Practice Address - Street 1:3063 ORLEANS DR
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-5330
Practice Address - Country:US
Practice Address - Phone:805-988-6197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18798103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical