Healthcare Provider Details

I. General information

NPI: 1760112593
Provider Name (Legal Business Name): EMBER L PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 W HENDERSON AVE STE 2
PORTERVILLE CA
93257-1490
US

IV. Provider business mailing address

520 E TULARE AVE
VISALIA CA
93292-3629
US

V. Phone/Fax

Practice location:
  • Phone: 559-788-1200
  • Fax: 559-713-3717
Mailing address:
  • Phone: 559-623-0900
  • Fax: 559-749-9823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: