Individual provider Active NPI

Emy Czerina Perez

  • Marriage & Family Therapist
  • San Bernardino, CA
National Provider Identifier
1497268379
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
142622 Issued in CA
Practice address
658 E Brier Dr Ste 200
San Bernardino, CA 92408-2847
Phone
(909) 501-0700
Fax
(909) 387-7611
NPI assigned
Nov 14, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 142622 CA Primary

Addresses

Primary practice location

658 E Brier Dr Ste 200
San Bernardino, CA 92408-2847

Mailing address

6227 Umbra Rd
Banning, CA 92220-1010
Phone (909) 806-0458

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

OrganizationSpecialtyStatusNew patients
County of San Bernardino CurrentSince Nov 26, 2023 Accepting new patients
Autism Center Committed to Educate Scientifically PastSince Apr 17, 2022 Accepting new patients
Autism Spectrum Intervention Services and Training (Asist) Past Accepting new patients

Locations

658 E Brier Dr
Ste 200
San Bernardino, CA 92408
Phone (909) 501-0700

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1497268379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6227 UMBRA RD",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922201010",
            "telephone_number": "909-806-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 E BRIER DR STE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082847",
            "telephone_number": "909-501-0700",
            "fax_number": "909-387-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "EMY",
        "middle_name": "CZERINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-14",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "142622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.