Healthcare Provider Details

I. General information

NPI: 1699681981
Provider Name (Legal Business Name): ANTHONY PERFETTO WILLIAM ANTHONY PERFETTO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13247 FOOTHILL BLVD 8-207
RANCHO CUCAMONGA CA
91739
US

IV. Provider business mailing address

831 E ARROW HWY
POMONA CA
91767-2535
US

V. Phone/Fax

Practice location:
  • Phone: 919-753-8720
  • Fax:
Mailing address:
  • Phone: 919-753-8720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: