Healthcare Provider Details

I. General information

NPI: 1982133906
Provider Name (Legal Business Name): MARIA JOSE PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2017
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 DORE ST
SAN FRANCISCO CA
94103-3828
US

IV. Provider business mailing address

368 FELL ST
SAN FRANCISCO CA
94102-5144
US

V. Phone/Fax

Practice location:
  • Phone: 415-861-0828
  • Fax: 415-861-0140
Mailing address:
  • Phone: 415-861-0828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number757205
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1982133906
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: