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General NPI Number Information
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NPI Number | 1184058463
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Entity Type | Individual
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Provider Name | JOHANNA NATALIE PEREZ LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/22/2013
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 1403 LOMITA BLVD
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City | HARBOR CITY
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State | CA
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Zip | 90710-2076
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Country | US
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Telephone | 213-514-0073
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Fax |
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Provider Business Mailing Address
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Address Line | 17707 STUDEBAKER RD
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City | CERRITOS
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State | CA
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Zip | 90703-2640
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Country | US
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Telephone | 310-402-0688
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 87157
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License Number State | CA
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