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General NPI Number Information
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NPI Number | 1972297091
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Entity Type | Individual
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Provider Name | JESSICA PEREZ LVN
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Gender | Female
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 1159 N CONWELL AVE APT 323
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City | COVINA
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State | CA
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Zip | 91722-1335
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Country | US
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Telephone | 626-502-3229
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Fax |
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Provider Business Mailing Address
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Address Line | 1159 N CONWELL AVE APT 323
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City | COVINA
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State | CA
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Zip | 91722-1335
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Country | US
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Telephone | 626-502-3229
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | VN710993
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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