MEDICARE: MRS. JESSICA BRIGITTE PEREZ MSW

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	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1831229079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSICA BRIGITTE PEREZ MSW

Provider Business Mailing Address
First Line	:	11721 WHITTIER BLVD # 149
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-3939
Country	:	US
Telephone Number	:	562-567-7417
Fax Number	:

Provider Business Practice Location Address
First Line	:	12501 PHILADELPHIA ST
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-3900
Country	:	US
Telephone Number	:	562-567-7417
Fax Number	:

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	01/03/2022

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