Healthcare Provider Details

I. General information

NPI: 1023941747
Provider Name (Legal Business Name): ROXANNA PEREZ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3970 W 24TH ST STE 204
YUMA AZ
85364-9261
US

IV. Provider business mailing address

3970 W 24TH ST STE 204
YUMA AZ
85364-9261
US

V. Phone/Fax

Practice location:
  • Phone: 928-373-8041
  • Fax: 928-259-2501
Mailing address:
  • Phone: 928-373-8041
  • Fax: 928-259-2501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number24904
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: