Active NPI
Jackieline Perez
- Rehabilitation Practitioner
- San Diego, CA
National Provider Identifier
1033845680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 165484
- Practice address
- 1260 Morena Blvd Ste 200
San Diego, CA 92110-3850 - Phone
- (619) 398-3261
- Fax
- (619) 275-2023
- NPI assigned
- Jul 26, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 165484 | CA | Primary |
| Day Training/Habilitation Specialist | 373H00000X | |||
| Rehabilitation Practitioner | 225400000X |
Addresses
Primary practice location
1260 Morena Blvd Ste 200
San Diego, CA 92110-3850
Mailing address
1260 Morena Blvd Ste 200
San Diego, CA 92110-3850
Phone (619) 398-3261
Other practice location 1
1202 Morena Blvd Ste 100
San Diego, CA 92110-3842
Phone (619) 275-0822
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Research Foundation Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1497978910
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789603200000",
"number": "1033845680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1260 MORENA BLVD STE 200",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103850",
"telephone_number": "619-398-3261",
"fax_number": "619-275-2023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1260 MORENA BLVD STE 200",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103850",
"telephone_number": "619-398-3261",
"fax_number": "619-275-2023"
}
],
"practiceLocations": [
{
"address_1": "1202 Morena Blvd Ste 100",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921103842",
"country_code": "US",
"telephone_number": "619-275-0822",
"fax_number": "619-275-1422",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEREZ",
"first_name": "JACKIELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-26",
"last_updated": "2026-09-17",
"certification_date": "2026-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "165484",
"primary": true
},
{
"code": "373H00000X",
"taxonomy_group": "",
"desc": "Day Training/Habilitation Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.