Provider Demographics
NPI:1700323110
Name:ACOSTA-PEREZ, DELIA
Entity Type:Individual
Prefix:
First Name:DELIA
Middle Name:
Last Name:ACOSTA-PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1393 BAILEY ST
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5922
Mailing Address - Country:US
Mailing Address - Phone:559-469-7039
Mailing Address - Fax:
Practice Address - Street 1:1393 BAILEY ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5922
Practice Address - Country:US
Practice Address - Phone:559-469-7039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW34741101YM0800X
CAASW85740101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health