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NPI Code Detail

MEDICARE: STACY PEREZ LPT

MEDICARE:   STACY  PEREZ  LPT
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1831649920
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY PEREZ LPT
Provider Business Mailing Address
First Line : 1374 STEELE CANYON RD
Second Line :
City : NAPA
State : CA
Zip : 94558-9771
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1374 STEELE CANYON RD
Second Line :
City : NAPA
State : CA
Zip : 94558-9771
Country : US
Telephone Number : 707-738-3835
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2016
Last Update Date : 10/12/2016

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Directions to “ STACY PEREZ LPT” Practice Location

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