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NPI Code Detail

MEDICARE: KRYSTAL PEREZ

MEDICARE: KRYSTAL PEREZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1285198093
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRYSTAL PEREZ
Provider Business Mailing Address
First Line : 612 S MYRTLE AVE STE 100
Second Line :
City : MONROVIA
State : CA
Zip : 91016-3406
Country : US
Telephone Number : 951-686-8500
Fax Number :
Provider Business Practice Location Address
First Line : 6876 MAGNOLIA AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506-2860
Country : US
Telephone Number : 800-207-0272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2019
Last Update Date : 03/27/2026

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Directions to “ KRYSTAL PEREZ ” Practice Location

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