Healthcare Provider Details

I. General information

NPI: 1568252708
Provider Name (Legal Business Name): BLANCA BERENICE PEREZ-SCHWAB MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2025
Last Update Date: 05/10/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 N STAR WAY
MODESTO CA
95356-9262
US

IV. Provider business mailing address

250 TIMBERWOOD DR
OAKDALE CA
95361-8227
US

V. Phone/Fax

Practice location:
  • Phone: 209-577-1200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: