Healthcare Provider Details

I. General information

NPI: 1336356286
Provider Name (Legal Business Name): CELESTE PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10802 RUSTIC LN
ANAHEIM CA
92804-6356
US

IV. Provider business mailing address

1230 S BAKER ST
SANTA ANA CA
92707-1004
US

V. Phone/Fax

Practice location:
  • Phone: 714-761-5997
  • Fax:
Mailing address:
  • Phone: 714-668-9383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number13309
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: