MEDICARE: DR. JUAN CAZARES PEREZ PSY.D.

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
1	103TC0700X	Clinical Psychologist	PSY#14184	CA

General Provider Information

NPI Number	:	1295833242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN CAZARES PEREZ PSY.D.

Provider Business Mailing Address
First Line	:	1181 BELL ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91104-2938
Country	:	US
Telephone Number	:	323-481-1852
Fax Number	:	800-307-9438

Provider Business Practice Location Address
First Line	:	595 E COLORADO BLVD
Second Line	:	SUITE 800
City	:	PASADENA
State	:	CA
Zip	:	91101-2039
Country	:	US
Telephone Number	:	800-314-7273
Fax Number	:	800-307-9438

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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