Tila Maria Laclette Perez

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

117078 Issued in CA

Practice address

22445 Alessandro Blvd # 113-114
Moreno Valley, CA 92553-8358

Phone

(951) 924-9791

NPI assigned

Apr 29, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1124763628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5242 FALKIRK AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925061572",
            "telephone_number": "708-262-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22445 ALESSANDRO BLVD # 113-114",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925538358",
            "telephone_number": "951-924-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACLETTE PEREZ",
        "first_name": "TILA",
        "middle_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "7127",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "117078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chang Hun Kwon
• Sue Min Sophia Kwon, MD
• Tammie Kwong, DO, MPH
• Anita Renee Kyles
• E Kyu, DDS
• Adam Lafleur
• Gussie Laguitan, RN
• Derick J Lajom, D.C.
• Hong My Lam
• Vicky Thanh Lam

• Marriage & Family Therapist in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.