Provider Demographics
NPI:1922351618
Name:PELAYO, PERLA
Entity Type:Individual
Prefix:MRS
First Name:PERLA
Middle Name:
Last Name:PELAYO
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 1:1201 N CALIFORNIA ST
Mailing Address - Street 2:#38
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-5000
Mailing Address - Country:US
Mailing Address - Phone:626-674-6707
Mailing Address - Fax:
Practice Address - Street 1:2000 TYLER AVE
Practice Address - Street 2:
Practice Address - City:SOUTH EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-3543
Practice Address - Country:US
Practice Address - Phone:626-442-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 26458101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health