Healthcare Provider Details

I. General information

NPI: 1619528247
Provider Name (Legal Business Name): CHRISTINA PEREZ MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA SOTO MSW

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 E COTTON CENTER BLVD STE 250
PHOENIX AZ
85040-4806
US

IV. Provider business mailing address

1912 N 201ST AVE
BUCKEYE AZ
85396-8707
US

V. Phone/Fax

Practice location:
  • Phone: 602-633-1828
  • Fax:
Mailing address:
  • Phone: 623-225-6074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: