Active NPI
Anna L. Perez, R.A.S.
- Children's Substance Abuse Rehabilitation Facility
- Cameron Park, CA
National Provider Identifier
1629322102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Children's Substance Abuse Rehabilitation Facility
- License
- 942535820
- Practice address
- 4459 Voltaire Drive
Cameron Park, CA 95682-7309 - Phone
- (530) 676-8422
- NPI assigned
- Nov 5, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Children's Substance Abuse Rehabilitation Facility | 3245S0500X | 942535820 | CA | Primary |
Addresses
Primary practice location
4459 Voltaire Drive
Cameron Park, CA 95682-7309
Mailing address
4459 Voltaire Dr
Cameron Park, CA 95682-7309
Phone (530) 409-2067
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215072293 | Other | CA | PROGRESS HOUSE INC. |
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 |
|---|---|---|---|
| 942535820 | CA | MD | Children's Substance Abuse Rehabilitation Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352073600000",
"number": "1629322102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4459 VOLTAIRE DR",
"city": "CAMERON PARK",
"state": "CA",
"postal_code": "956827309",
"telephone_number": "530-409-2067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4459 VOLTAIRE DRIVE",
"city": "CAMERON PARK",
"state": "CA",
"postal_code": "956827309",
"telephone_number": "530-676-8422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "ANNA",
"middle_name": "L.",
"credential": "R.A.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-05",
"last_updated": "2012-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "3245S0500X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
"state": "CA",
"license": "942535820",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROGRESS HOUSE INC.",
"identifier": "1215072293",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cameron Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.