Provider Demographics
NPI:1841070026
Name:PERKINS, JAMES BIJOY
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:BIJOY
Last Name:PERKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131B STONY CIRCLE
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401
Mailing Address - Country:US
Mailing Address - Phone:510-317-1444
Mailing Address - Fax:
Practice Address - Street 1:131B STONY CIRCLE
Practice Address - Street 2:SUITE 1200
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4124
Practice Address - Country:US
Practice Address - Phone:707-230-3803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2024-08-30
Deactivation Date:2024-07-01
Deactivation Code:
Reactivation Date:2024-08-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No171M00000XOther Service ProvidersCase Manager/Care Coordinator