Provider Demographics
NPI:1801609698
Name:PEREZ SORIA, JIMENA
Entity type:Individual
Prefix:
First Name:JIMENA
Middle Name:
Last Name:PEREZ SORIA
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 1:265 S BECKWITH RD SPC 15A
Mailing Address - Street 2:
Mailing Address - City:SANTA PAULA
Mailing Address - State:CA
Mailing Address - Zip Code:93060-4415
Mailing Address - Country:US
Mailing Address - Phone:805-561-0990
Mailing Address - Fax:
Practice Address - Street 1:4880 MARKET ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7783
Practice Address - Country:US
Practice Address - Phone:805-364-8521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician