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NPI Code Detail

MEDICARE: MARISOLLE DENNISE PEREZ

MEDICARE:   MARISOLLE DENNISE 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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1821678756
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISOLLE DENNISE PEREZ
Provider Business Mailing Address
First Line : 21600 OXNARD ST
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-4976
Country : US
Telephone Number : 818-345-2345
Fax Number :
Provider Business Practice Location Address
First Line : 8302 ESPRESSO DR
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93312-5687
Country : US
Telephone Number : 661-520-9292
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2021
Last Update Date : 12/02/2022

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Directions to “ MARISOLLE DENNISE PEREZ ” Practice Location

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