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NPI Code Detail

MEDICARE: VANESSA PEREZ

MEDICARE: VANESSA 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
1172V00000XCommunity Health Worker360071ANCA

General Provider Information

NPI Number : 1972454320
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA PEREZ
Provider Business Mailing Address
First Line : PO BOX 25040
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92406-0640
Country : US
Telephone Number : 909-886-2994
Fax Number : 909-886-0218
Provider Business Practice Location Address
First Line : 2164 N MOUNTAIN VIEW AVE
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92405-4019
Country : US
Telephone Number : 909-886-2994
Fax Number : 909-886-0218
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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Directions to “ VANESSA PEREZ ” Practice Location

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