Provider Demographics
NPI:1619079498
Name:PEREZ, REBECA
Entity Type:Individual
Prefix:MRS
First Name:REBECA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S8 CALLE 6
Mailing Address - Street 2:SANS SOUCI
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957-4318
Mailing Address - Country:US
Mailing Address - Phone:787-797-3786
Mailing Address - Fax:
Practice Address - Street 1:S8 CALLE 6
Practice Address - Street 2:SANS SOUCI
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-4318
Practice Address - Country:US
Practice Address - Phone:787-797-3786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR81101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical