Charlie R Perez, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95031274 Issued in CA

Practice address

158 C Ave
Coronado, CA 92118-1420

Phone

(619) 435-5400

NPI assigned

Jul 30, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Crownview Medical Group IncGroup PAC ID 2668524323, 7 clinicians

Pacific Health Systems LPGroup PAC ID 7911901392, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Crownview Medical Group, Inc

  • Psychiatry Physician
  • Coronado, CA
  • NPI 1598928798
  Medicare reassignment Care Compare group NPD
• Pacific Health Systems, L.P.

  • Psychiatry Physician
  • National City, CA
  • NPI 1669486429
  Medicare reassignment Care Compare group
• Advanced TMS Clinic Inc

  • Clinic/Center
  • National City, CA
  • NPI 1386104263
  Medicare reassignment

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1497584239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 C AVE",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181420",
            "telephone_number": "619-435-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 C AVE",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181420",
            "telephone_number": "619-435-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "CHARLIE",
        "middle_name": "R",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95031274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parmela Sawhney MD Inc
• Patrick R Yassini M D Inc
• Sarah R Peck, COTA
• John Richard Pedrotty Jr., MD
• Gila Peled, LICENCED ACUPUNCTURE
• Stephanie Perez
• Peter R. Kelly M.D. Inc
• Deanna Sue Petersen, LCSW
• Laura Norton Petrovich, MD
• Michelle Pham, OD

• Psychiatric/Mental Health Nurse Practitioner in Coronado, CA
• Providers in Coronado, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.