Healthcare Provider Details

I. General information

NPI: 1841369014
Provider Name (Legal Business Name): BRETT HILARY PERALTA PSY. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 W METROPOLITAN DR STE 403
ORANGE CA
92868-3504
US

IV. Provider business mailing address

1725 W 17TH ST SUITE 146B
SANTA ANA CA
92706-2316
US

V. Phone/Fax

Practice location:
  • Phone: 714-949-5136
  • Fax:
Mailing address:
  • Phone: 714-834-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: