Healthcare Provider Details

I. General information

NPI: 1447902465
Provider Name (Legal Business Name): ROLANDO PEREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2022
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22802 RIO CHICO DR
VALENCIA CA
91354-2265
US

IV. Provider business mailing address

3186 AIRWAY AVE STE A
COSTA MESA CA
92626-4650
US

V. Phone/Fax

Practice location:
  • Phone: 661-673-6810
  • Fax:
Mailing address:
  • Phone: 714-881-0427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-15-18
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: