Healthcare Provider Details

I. General information

NPI: 1679135362
Provider Name (Legal Business Name): BIBIANA PEREZ AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2019
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46883 MONROE ST
INDIO CA
92201-6768
US

IV. Provider business mailing address

46883 MONROE ST
INDIO CA
92201-6768
US

V. Phone/Fax

Practice location:
  • Phone: 760-398-9090
  • Fax: 760-391-5338
Mailing address:
  • Phone: 760-398-9090
  • Fax: 760-391-5338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number160801
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: