Provider Demographics
NPI:1649787953
Name:PEREZ, DANIEL JAMES (LMFT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAMES
Last Name:PEREZ
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 DELTA FAIR BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-4074
Mailing Address - Country:US
Mailing Address - Phone:925-303-6058
Mailing Address - Fax:925-481-2733
Practice Address - Street 1:3700 DELTA FAIR BLVD STE 210
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4074
Practice Address - Country:US
Practice Address - Phone:925-303-6058
Practice Address - Fax:925-481-2733
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-08
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101370106H00000X
CAMFC130897106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist