Provider Demographics
NPI:1902363625
Name:PEREZ, ANNE JILIAN TIANGCO (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ANNE JILIAN
Middle Name:TIANGCO
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 SAINT VINCENT
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3933
Mailing Address - Country:US
Mailing Address - Phone:949-212-7741
Mailing Address - Fax:
Practice Address - Street 1:556 SAINT VINCENT
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3933
Practice Address - Country:US
Practice Address - Phone:949-212-7741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-28
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT295714225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist