Healthcare Provider Details

I. General information

NPI: 1174851638
Provider Name (Legal Business Name): CYNTHIA ELIDE PEREZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA ELIDE ALONZO

II. Dates (important events)

Enumeration Date: 11/21/2009
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 WILSHIRE BLVD FL 19
LOS ANGELES CA
90048-4920
US

IV. Provider business mailing address

11579 MIDWAY DR
CYPRESS CA
90630-5530
US

V. Phone/Fax

Practice location:
  • Phone: 805-764-9651
  • Fax: 747-330-1670
Mailing address:
  • Phone: 480-980-2633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29856
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: