Individual provider Active NPI

Jose Perez

  • Counselor
  • Yakima, WA
National Provider Identifier
1063583185
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CG60112080 Issued in WA
Practice address
1114 S 7TH Ave
Yakima, WA 98902-5502
Phone
(509) 307-7638
NPI assigned
Nov 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CG60112080 WA Primary

Addresses

Primary practice location

1114 S 7TH Ave
Yakima, WA 98902-5502

Mailing address

1114 S 7TH Ave
Yakima, WA 98902-5502
Phone (509) 307-7638

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

State licenses

LicenseStateTypeSpecialty
CG60112080WAMDCounselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1063583185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 S 7TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989025502",
            "telephone_number": "509-307-7638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 S 7TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989025502",
            "telephone_number": "509-307-7638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JOSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-11",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG60112080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.