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General NPI Number Information
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NPI Number | 1740982867
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Entity Type | Individual
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Provider Name | ARMANDO PEREZ
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Gender | Male
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Dates
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Enumeration Date | 03/21/2023
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 421 E MORRIS AVE
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City | MODESTO
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State | CA
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Zip | 95354-0437
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Country | US
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Telephone | 209-552-2819
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Fax |
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Provider Business Mailing Address
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Address Line | 522 E GRANGER AVE
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City | MODESTO
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State | CA
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Zip | 95350-4545
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Country | US
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Telephone | 209-558-4610
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374700000X
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Taxonomy Name | Technician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State | CA
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