Provider Demographics
NPI:1730679564
Name:PEREZ, CLAUDIA I
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:I
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 1:3830 EZEKIEL LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-9484
Mailing Address - Country:US
Mailing Address - Phone:915-319-8308
Mailing Address - Fax:
Practice Address - Street 1:3830 EZEKIEL LN
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-9484
Practice Address - Country:US
Practice Address - Phone:915-319-8308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician