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NPI Code Detail

MEDICARE: ILSE PEREZ PRECIADO

MEDICARE: ILSE PEREZ PRECIADO
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
1101YM0800XMental Health Counselor
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1376195537
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILSE PEREZ PRECIADO
Provider Business Mailing Address
First Line : 3350 SHELBY ST STE 230
Second Line :
City : ONTARIO
State : CA
Zip : 91764-4883
Country : US
Telephone Number : 951-284-7300
Fax Number : 909-284-7300
Provider Business Practice Location Address
First Line : 3350 SHELBY ST STE 230
Second Line :
City : ONTARIO
State : CA
Zip : 91764-4883
Country : US
Telephone Number : 909-284-7300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2019
Last Update Date : 11/24/2025

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Directions to “ ILSE PEREZ PRECIADO ” Practice Location

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