Healthcare Provider Details

I. General information

NPI: 1801714837
Provider Name (Legal Business Name): MICAELA HELEN PERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29714 HAUN RD
MENIFEE CA
92586-6540
US

IV. Provider business mailing address

19069 VAN BUREN BLVD. STE 114 #425
RIVERSIDE CA
92508-9171
US

V. Phone/Fax

Practice location:
  • Phone: 951-486-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number135785
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: