MEDICARE: ROLANDO 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
1	106E00000X	Assistant Behavior Analyst
2	103K00000X	Behavior Analyst	1-15-18

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447902465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROLANDO PEREZ

Provider Business Mailing Address
First Line	:	3186 AIRWAY AVE STE A
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92626-4650
Country	:	US
Telephone Number	:	714-881-0427
Fax Number	:

Provider Business Practice Location Address
First Line	:	22802 RIO CHICO DR
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91354-2265
Country	:	US
Telephone Number	:	661-673-6810
Fax Number	:

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

Provider Enumeration Date	:	01/20/2022
Last Update Date	:	03/24/2026

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Directions to “ ROLANDO PEREZ ” Practice Location

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