Kelly Perez

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

9150 Waterman Rd Apt 116
Elk Grove, CA 95624-5079

Phone

(916) 886-6255

NPI assigned

Jul 3, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1720640394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9150 WATERMAN RD APT 116",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956245079",
            "telephone_number": "916-886-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9150 WATERMAN RD APT 116",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956245079",
            "telephone_number": "916-886-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERCOASTCOLLEGE",
            "identifier": "12345",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "InterCoastCollege",
            "affiliation": "N",
            "endpointDescription": "InterCoastCollege",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "InterCoastCollege",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "InterCoastCollege",
            "address_1": "9150 Waterman Rd Apt 116",
            "city": "Elk Grove",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956245079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Josephine Perez Solis
• Ezra Jon Perez-Lopez
• Maria Perez-Parra
• Arturo Perez
• Diana Perez
• Shannon C Perez, CCC-SLP
• Valeria Perez
• Perfect Grace HHA Inc
• Deborah Ann Perkins, R.N.
• Rosalie Anja Perrot, MD

• Addiction (Substance Use Disorder) Counselor in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.