Doctor Name: | REBECCA J PEREZ |
NPI Number: | 1003824186 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 17163 |
Business Practice Address: | 2201 Courage Dr Fairfield, CA - 945336733 |
Business Phone Number: | 0707842010 |
Business Fax Number: | 7077841495 |
Mailing Address: | 2201 Courage Dr, FAIRFIELD |
State: | CA |
Postal Code: | 945336733 |
Phone Number: | 0707842010 |
Fax Number: | |
NPI Enumeration Date: | 08/04/2006 |
NPI Last Update Date: | 03/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 17163 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |