Provider Demographics
NPI:1639202286
Name:PEREZ, LILIANA GUADALUPE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:LILIANA
Middle Name:GUADALUPE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5622
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91221-5622
Mailing Address - Country:US
Mailing Address - Phone:559-240-9826
Mailing Address - Fax:
Practice Address - Street 1:976 1/2 W GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2761
Practice Address - Country:US
Practice Address - Phone:559-240-9826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical