Provider Demographics
NPI: | 1881026342 |
---|---|
Name: | PEREZ, NORMAN JAVIER (MA) |
Entity type: | Individual |
Prefix: | MR |
First Name: | NORMAN |
Middle Name: | JAVIER |
Last Name: | PEREZ |
Suffix: | |
Gender: | M |
Credentials: | MA |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 811 CALLE ROBLES |
Mailing Address - Street 2: | ESTANCIAS DEL BOSQUE |
Mailing Address - City: | CIDRA |
Mailing Address - State: | PR |
Mailing Address - Zip Code: | 00739-8410 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 787-310-9342 |
Mailing Address - Fax: | |
Practice Address - Street 1: | CARRETERA 172 KM 7.6 |
Practice Address - Street 2: | |
Practice Address - City: | CIDRA |
Practice Address - State: | PR |
Practice Address - Zip Code: | 00739-8410 |
Practice Address - Country: | US |
Practice Address - Phone: | 787-310-9342 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2013-08-06 |
Last Update Date: | 2013-08-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PR | 4827 | 103K00000X, 103TA0400X, 103TA0700X, 103TB0200X, 103TC1900X, 103TC2200X, 103TF0000X, 103TF0200X, 103TH0004X, 103TH0100X, 103TM1800X, 103TP2701X, 103TR0400X, 103TS0200X, 106H00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 103TC1900X | Behavioral Health & Social Service Providers | Psychologist | Counseling |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | |
No | 103TA0400X | Behavioral Health & Social Service Providers | Psychologist | Addiction (Substance Use Disorder) |
No | 103TA0700X | Behavioral Health & Social Service Providers | Psychologist | Adult Development & Aging |
No | 103TB0200X | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral |
No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent |
No | 103TF0000X | Behavioral Health & Social Service Providers | Psychologist | Family |
No | 103TF0200X | Behavioral Health & Social Service Providers | Psychologist | Forensic |
No | 103TH0004X | Behavioral Health & Social Service Providers | Psychologist | Health |
No | 103TH0100X | Behavioral Health & Social Service Providers | Psychologist | Health Service |
No | 103TM1800X | Behavioral Health & Social Service Providers | Psychologist | Intellectual & Developmental Disabilities |
No | 103TP2701X | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy |
No | 103TR0400X | Behavioral Health & Social Service Providers | Psychologist | Rehabilitation |
No | 103TS0200X | Behavioral Health & Social Service Providers | Psychologist | School |
No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist |