Provider Demographics
NPI:1558496968
Name:P.E.R.T INCORPORATED
Entity type:Organization
Organization Name:P.E.R.T INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FIX
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:619-276-8112
Mailing Address - Street 1:1094 CUDAHY PL
Mailing Address - Street 2:SUITE 314
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-3931
Mailing Address - Country:US
Mailing Address - Phone:619-276-8112
Mailing Address - Fax:619-276-8230
Practice Address - Street 1:1094 CUDAHY PL
Practice Address - Street 2:SUITE 314
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-3931
Practice Address - Country:US
Practice Address - Phone:619-276-8112
Practice Address - Fax:619-276-8230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare