KELLY PEREZ (NPI# 1720640394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720640394 |
| Entity Type | Individual |
| Full Name | KELLY PEREZ |
| Practice Address |
9150 Waterman Rd Apt 116 Elk Grove CA 95624-5079 |
| Practice Telephone | 9168866255 |
| Mailing Telephone | 9168866255 |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2019-07-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | INTERCOASTCOLLEGE | 12345 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184173908 | Kelly Perez | Marriage & Family Therapist | 84-14 Queens Blvd, Elmhurst, NY 11373 | 2016-09-22 |
| 1730412172 | Kelly Sue Perez | Physician Assistant | 7500 Smoke Ranch Rd Ste 200, Las Vegas, NV 89128-0373 | 2009-09-17 |
| 1003448036 | Kelly Allin Perez | Counselor | 1500 Hughes Way Ste C100, Long Beach, CA 90810-1808 | 2020-02-07 |
| 1114581055 | Kelly Stephanie Perez | Social Worker | 1405 Spruce St, Riverside, CA 92507-2464 | 2019-04-25 |
| 1679057236 | Kelly Perez | Marriage & Family Therapist | 2790 Skypark Dr Ste 215, Torrance, CA 90505-5388 | 2018-09-19 |
| 1194261693 | Kelly Perez | Behavioral Analyst | 807 Lawn Ave, Sellersville, PA 18960-1549 | 2017-01-09 |
| 1902277643 | Kelly Lynn Perez | Nurse Practitioner | 4875 Higbee Ave Nw, Canton, OH 44718-2566 | 2015-10-07 |
| 1548491178 | Kelly Lynn Perez | Pharmacist | 820 S Damen Ave, Pharmacy Service 119, Chicago, IL 60612-3728 | 2009-07-30 |
| 1053565366 | Kelly Jean Perez | Dietitian, Registered | 4076 Neely Rd, Ft. Wainwright, AK 99703 | 2008-11-13 |
| 1376629493 | Kelly Perez | Physician Assistant | 1700 Oak Ave, Muskegon, MI 49442-2407 | 2006-10-31 |
| Street Address |
9150 WATERMAN RD APT 116 |
| City | ELK GROVE |
| State | CA |
| Zip Code | 95624-5079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194363721 | Sanam Adela Baidar | Behavior Technician | 9170 Dino Dr, Ste 170, Elk Grove, CA 95624 | 2019-12-13 |
| 1134686041 | Hannah Marie Hamm | Behavior Technician | 9701 Dino Drive, Suite 170, Elk Grove, CA 95624 | 2019-02-27 |
| 1538624259 | Amnah Sattar | Assistant Behavior Analyst | 9701 Dino Dr, Elk Grove, CA 95624 | 2019-02-06 |
| 1740793470 | Sheena Maharaj | Marriage & Family Therapist | 9008 Elk Grove Blvd Ste 11, Elk Grove, CA 95624 | 2017-11-16 |
| 1598285595 | Jessica Russo | Behavior Technician | 8672 Cycladic Ct, Elk Grove, CA 95624 | 2017-06-21 |
| 1982137568 | Jamie Kofoed | Behavioral Analyst | 9355 E Stockton Blvd Ste 100, Elk Grove, CA 95624 | 2017-04-10 |
| 1154878742 | Dorian Elaine Buckner | Counselor | 9355 E. Stockton Blvd., Elk Grove, CA 95624 | 2016-09-01 |
| 1447635529 | David Johnson | Student in an Organized Health Care Education/Training Program | 9666 Kent St, Elk Grove, CA 95624 | 2015-07-30 |
| 1760862437 | Harpreet Singh | Student in an Organized Health Care Education/Training Program | 8617 Orison Ct, Elk Grove, CA 95624 | 2015-06-08 |
| 1942698253 | Noah Shapiro | Social Worker | 9140 Bradshaw Rd, Elf Grove, CA 95624 | 2015-01-08 |
| Find all providers in zip 95624 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447737333 | Elk Grove Rehab & Counseling Center | Counselor | 7807 Laguna Blvd., Suite 480, Elk Grove, CA 95758 | 2018-07-24 |
| 1558818039 | Shayla C Harris | Counselor | 9355 E Stockton Blvd, Elk Grove, CA 95624-9476 | 2016-09-01 |
| 1154878742 | Dorian Elaine Buckner | Counselor | 9355 E. Stockton Blvd., Elk Grove, CA 95624 | 2016-09-01 |
| 1679930390 | Sean Donovan | Counselor | 9451 Havenview Way, Elk Grove, CA 95624-6032 | 2016-01-26 |
| 1063877132 | Brian Lyttle I | Counselor | 9514 Coney Island Cir, Elk Grove, CA 95758-3646 | 2015-12-16 |
| 1508244807 | Maria De Los Angeles Garcia | Counselor | 10423 Canadeo Cir, Elk Grove, CA 95757-3549 | 2015-05-07 |
| 1821475211 | Catrin Trevena Phillips | Counselor | 9370 Marlemont Cir, Elk Grove, CA 95758-7605 | 2015-05-05 |
| 1104228980 | Anthony J Scuderi | Counselor | 9964 Winkle Circle, Elk Grove, CA 95757-1904 | 2014-09-23 |
| 1861435547 | George Moschke | Counselor | 8981 Park Meadows Dr, Elk Grove, CA 95624-2720 | 2006-06-13 |
| 1386825883 | Shevonne Marie Radich | Counselor | 8841 Williamson Dr Ste 40, Elk Grove, CA 95624-1800 | 2007-11-26 |
| Find all providers in ELK GROVE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.