Healthcare Provider Details

I. General information

NPI: 1245759349
Provider Name (Legal Business Name): HUI PEREZ FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2017
Last Update Date: 09/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 HOSPITAL WAY
MATHER CA
95655-4200
US

IV. Provider business mailing address

842 WINDSOR CT
VACAVILLE CA
95688-9475
US

V. Phone/Fax

Practice location:
  • Phone: 916-366-5406
  • Fax:
Mailing address:
  • Phone: 707-514-7785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95007170
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: