Healthcare Provider Details

I. General information

NPI: 1831011261
Provider Name (Legal Business Name): KIARA PRAK-PERRY
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 ALBERTA WAY
CONCORD CA
94521-3747
US

IV. Provider business mailing address

1890 JOHN MUIR PKWY
HERCULES CA
94547-2790
US

V. Phone/Fax

Practice location:
  • Phone: 925-682-7474
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: