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NPI Code Detail

MEDICARE: JESSE PEREZ

MEDICARE: JESSE 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 TechnicianCA

General Provider Information

NPI Number : 1902440332
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSE PEREZ
Provider Business Mailing Address
First Line : 3350 SHELBY ST STE 200
Second Line :
City : ONTARIO
State : CA
Zip : 91764-5556
Country : US
Telephone Number : 818-208-0164
Fax Number : 855-621-8966
Provider Business Practice Location Address
First Line : 3350 SHELBY ST STE 200
Second Line :
City : ONTARIO
State : CA
Zip : 91764-5556
Country : US
Telephone Number : 818-208-0164
Fax Number : 855-621-8966
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2019
Last Update Date : 10/12/2025

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Directions to “ JESSE PEREZ ” Practice Location

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