MEDICARE: OLGA YADIRA PEREZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1326432543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLGA YADIRA PEREZ

Provider Business Mailing Address
First Line	:	445 N SAN JOAQUIN ST
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95202-2026
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7224 S RECOVERY RD
Second Line	:
City	:	FRENCH CAMP
State	:	CA
Zip	:	95231-8901
Country	:	US
Telephone Number	:	209-888-6595
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2015
Last Update Date	:	11/20/2025

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Directions to “ OLGA YADIRA PEREZ ” Practice Location

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