Healthcare Provider Details

I. General information

NPI: 1285559237
Provider Name (Legal Business Name): BRENDA PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32593 RIVERSIDE DR
LAKE ELSINORE CA
92530-7802
US

IV. Provider business mailing address

32593 RIVERSIDE DR
LAKE ELSINORE CA
92530-7802
US

V. Phone/Fax

Practice location:
  • Phone: 951-253-7300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberASW131987
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: