Provider Demographics
NPI:1790023703
Name:PEREZ, ALMA ANGELICA
Entity Type:Individual
Prefix:MS
First Name:ALMA
Middle Name:ANGELICA
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 1:4320 LOS FELIZ BLVD # 3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-2215
Mailing Address - Country:US
Mailing Address - Phone:562-884-2659
Mailing Address - Fax:
Practice Address - Street 1:4320 LOS FELIZ BLVD # 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-2215
Practice Address - Country:US
Practice Address - Phone:562-884-2659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-12-12052103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst