Healthcare Provider Details

I. General information

NPI: 1366102121
Provider Name (Legal Business Name): VERONICA MARIE PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2021
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 1ST ST
WOODLAND CA
95695-4023
US

IV. Provider business mailing address

455 1ST ST
WOODLAND CA
95695-4023
US

V. Phone/Fax

Practice location:
  • Phone: 530-662-2211
  • Fax:
Mailing address:
  • Phone: 530-662-2211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberR1629730825
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number136598
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: