MEDICARE: MR. JOB PEREZ JR

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	106H00000X	Marriage & Family Therapist	LMFT85904	CA

General Provider Information

NPI Number	:	1346453578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOB PEREZ JR

Provider Business Mailing Address
First Line	:	8175 LIMONITE AVE STE A
Second Line	:
City	:	JURUPA VALLEY
State	:	CA
Zip	:	92509-6120
Country	:	US
Telephone Number	:	866-222-2930
Fax Number	:

Provider Business Practice Location Address
First Line	:	8175 LIMONITE AVE STE A
Second Line	:
City	:	JURUPA VALLEY
State	:	CA
Zip	:	92509-6120
Country	:	US
Telephone Number	:	866-222-2930
Fax Number	:

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

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	04/28/2022

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Directions to “ MR. JOB PEREZ JR ” Practice Location

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