Provider Demographics
NPI:1477604643
Name:PEREZ, VERONICA BETH (PHD)
Entity type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:BETH
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10455 POMERADO ROAD
Mailing Address - Street 2:DALEY HALL
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1717
Mailing Address - Country:US
Mailing Address - Phone:619-432-2375
Mailing Address - Fax:
Practice Address - Street 1:10455 POMERADO ROAD
Practice Address - Street 2:DALEY HALL
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1717
Practice Address - Country:US
Practice Address - Phone:619-432-2375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAPSY27421103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health