Healthcare Provider Details

I. General information

NPI: 1598609794
Provider Name (Legal Business Name): SUSAN DE CASTRO PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7765 LEEDS ST
DOWNEY CA
90242-3489
US

IV. Provider business mailing address

18819 DE VOSS AVE
CERRITOS CA
90703-6055
US

V. Phone/Fax

Practice location:
  • Phone: 253-208-6131
  • Fax:
Mailing address:
  • Phone: 714-728-5138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95347415
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: