Provider Demographics
NPI:1922540194
Name:PEREZ, RAMONA RAQUEL RODRIGUEZ (AS, BS, MS)
Entity Type:Individual
Prefix:
First Name:RAMONA
Middle Name:RAQUEL RODRIGUEZ
Last Name:PEREZ
Suffix:
Gender:F
Credentials:AS, BS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4199 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-4684
Mailing Address - Country:US
Mailing Address - Phone:949-725-2972
Mailing Address - Fax:949-502-4725
Practice Address - Street 1:4199 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-4684
Practice Address - Country:US
Practice Address - Phone:949-725-2972
Practice Address - Fax:949-502-4725
Is Sole Proprietor?:No
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist