Mayra Perez Lopez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

97377 Issued in CA

Practice address

7425 Rancho Los Guilicos Rd
Santa Rosa, CA 95409-6519

Phone

(707) 565-6318

NPI assigned

Aug 27, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• R House, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Santa Rosa, CA
  • NPI 1760516702
  NPD (past)

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636848000000",
    "number": "1669605374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7425 RANCHO LOS GUILICOS RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954096519",
            "telephone_number": "707-565-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7425 RANCHO LOS GUILICOS RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954096519",
            "telephone_number": "707-565-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ LOPEZ",
        "first_name": "MAYRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2021-11-14",
        "certification_date": "2021-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "97377",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RI-P0908271359",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jody Lynn Pennycook, PA
• Daniel Peoples
• Frank Peoples
• Elizabeth A Peralta, M.D.
• Julianna Peraza, MS
• Cristal Lizbeth Perez Sierra
• Teresa Perez-Martinez, AMFT
• Alejandra Citlali Perez
• Angela Perez, LMT, CMT
• Bryan Perez

• Clinical Social Worker in Santa Rosa, CA
• Providers in Santa Rosa, 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 Nov 14, 2021; 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.