Provider Demographics
NPI:1184900284
Name:PEREZ, DAMARIS (ACSW)
Entity type:Individual
Prefix:MISS
First Name:DAMARIS
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6666 OWENS DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3334
Mailing Address - Country:US
Mailing Address - Phone:925-201-6242
Mailing Address - Fax:925-485-1273
Practice Address - Street 1:6666 OWENS DR
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3334
Practice Address - Country:US
Practice Address - Phone:925-201-6242
Practice Address - Fax:925-485-1273
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA310721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical