Provider Demographics
NPI:1356156814
Name:PEREZ, VICTOR FABIAN
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:FABIAN
Last Name:PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9140 VAN NUYS BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-6764
Mailing Address - Country:US
Mailing Address - Phone:818-895-2206
Mailing Address - Fax:
Practice Address - Street 1:9140 VAN NUYS BLVD STE 211
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-6764
Practice Address - Country:US
Practice Address - Phone:818-895-2206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)