Healthcare Provider Details

I. General information

NPI: 1922406537
Provider Name (Legal Business Name): ALEJANDRA PEREYRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2014
Last Update Date: 12/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N MAIN ST
SANTA ANA CA
92701-3640
US

IV. Provider business mailing address

1200 N MAIN ST
SANTA ANA CA
92701-3640
US

V. Phone/Fax

Practice location:
  • Phone: 714-824-8140
  • Fax: 714-824-8142
Mailing address:
  • Phone: 714-824-8140
  • Fax: 714-824-8142

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: