Healthcare Provider Details

I. General information

NPI: 1831423276
Provider Name (Legal Business Name): VERONICA E. PEREZ PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2009
Last Update Date: 01/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 7TH ST
WASCO CA
93280-1502
US

IV. Provider business mailing address

659 S CENTRAL VALLEY HWY
SHAFTER CA
93263-2790
US

V. Phone/Fax

Practice location:
  • Phone: 661-758-2263
  • Fax: 661-758-8132
Mailing address:
  • Phone: 661-459-1913
  • Fax: 661-459-1974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA20531
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: