Healthcare Provider Details

I. General information

NPI: 1295766129
Provider Name (Legal Business Name): NORMA ALICIA PEREZ PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1114 6TH ST
MODESTO CA
95354-2203
US

IV. Provider business mailing address

737 WEST CHILDS AVENUE
MERCED CA
95340-6805
US

V. Phone/Fax

Practice location:
  • Phone: 209-576-2845
  • Fax: 209-236-1290
Mailing address:
  • Phone: 209-383-1848
  • Fax: 209-384-3966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN643747
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number16790
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: