Active NPI
Melissa Rose Perez, MSW
- Student in an Organized Health Care Education/Training Program
- San Diego, CA
National Provider Identifier
1497937551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 2801 Meadow Lark Dr
San Diego, CA 92123-2709 - Phone
- (858) 694-4680
- NPI assigned
- Nov 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ASW28611 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | CA | Primary |
Addresses
Primary practice location
2801 Meadow Lark Dr
San Diego, CA 92123-2709
Mailing address
2801 Meadow Lark Dr
San Diego, CA 92123-2709
Phone (858) 694-4680
Other practice location 1
23504 Lyons Ave
Suite 204
Santa Clarita, CA 91321-2500
Phone (661) 286-2550 ext. 4002
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00245029 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| ASW28611 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532563200000",
"number": "1497937551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 MEADOW LARK DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921232709",
"telephone_number": "858-694-4680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 MEADOW LARK DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921232709",
"telephone_number": "858-694-4680"
}
],
"practiceLocations": [
{
"address_1": "23504 Lyons Ave",
"address_2": "Suite 204",
"address_purpose": "LOCATION",
"city": "Santa Clarita",
"state": "CA",
"postal_code": "913212500",
"country_code": "US",
"telephone_number": "661-286-2550 x4002",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEREZ",
"first_name": "MELISSA",
"middle_name": "ROSE",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-30",
"last_updated": "2018-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW28611",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00245029",
"state": "NY"
}
],
"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 Jul 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.