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NPI Code Detail

MEDICARE: NATALY PEREZ

MEDICARE: NATALY 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1679391106
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATALY PEREZ
Provider Business Mailing Address
First Line : 3766 S LA SALLE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90018-4551
Country : US
Telephone Number : 818-808-2101
Fax Number :
Provider Business Practice Location Address
First Line : 3210 W BURBANK BLVD
Second Line :
City : BURBANK
State : CA
Zip : 91505-2200
Country : US
Telephone Number : 818-638-9586
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2024
Last Update Date : 10/02/2024

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