Andrea Guadalupe Perez Portillo

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

96134 Issued in CA

Practice address

1375 Sycamore Ave Apt 211
Hercules, CA 94547-5519

Phone

(510) 253-5199

NPI assigned

Aug 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

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": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1639624489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 SYCAMORE AVE APT 211",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945475519",
            "telephone_number": "510-253-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 SYCAMORE AVE APT 211",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945475519",
            "telephone_number": "510-253-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ PORTILLO",
        "first_name": "ANDREA",
        "middle_name": "GUADALUPE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "74204",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "74204",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "74204",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "96134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helen Paek, O.D.
• Franz Panganiban
• Iraselma Estela Paniagua
• Pathology Processing Laboratory LLC
• Joyce Penalver
• Natalie Perez
• Oksana M Peters, PA
• Helaine Barbara Pleet, MD MPH
• Ramesha Powell
• Promolecular Diagnostics, LLC

• Clinical Social Worker in Hercules, CA
• Providers in Hercules, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.