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NPI Code Detail

MEDICARE: MS. DANA PEREZ

MEDICARE: MS. DANA 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
1225400000XRehabilitation Practitioner
2175T00000XPeer Specialist

General Provider Information

NPI Number : 1568911816
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DANA PEREZ
Provider Business Mailing Address
First Line : 709 5TH AVE
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-3202
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 709 5TH AVE
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-3202
Country : US
Telephone Number : 415-754-3329
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2016
Last Update Date : 04/20/2023

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