Healthcare Provider Details

I. General information

NPI: 1780593145
Provider Name (Legal Business Name): CHRISTIAN GRACE PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4945 W CYPRESS AVE
VISALIA CA
93277-1592
US

IV. Provider business mailing address

6124 W DELAWARE CT
VISALIA CA
93291-9760
US

V. Phone/Fax

Practice location:
  • Phone: 559-624-3050
  • Fax:
Mailing address:
  • Phone: 210-218-9318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number90984
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: