Individual provider Active NPI

Juan Manuel Perez, LCSW

  • Clinical Social Worker
  • Turlock, CA
National Provider Identifier
1730658683
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
82631 Issued in CA
Practice address
875 Geer Rd
Turlock, CA 95380-3311
Phone
(209) 633-3031
NPI assigned
Nov 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 82631 CA Primary

Addresses

Primary practice location

875 Geer Rd
Turlock, CA 95380-3311

Mailing address

724 Waddell Way
Modesto, CA 95357-1487
Phone (209) 585-8665

Other practice location 1

3605 Hospital Rd
Atwater, CA 95301-5173
Phone (209) 381-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210202000497 CA Practitioner - Clinical Social Worker 3072927466 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Alliance for Community Wellness CurrentSince Jul 1, 2024 Accepting new patients
The Alliance for Community Wellness CurrentSince Oct 15, 2020 Accepting new patients

Locations

24301 Southland Dr
Ste 300
Hayward, CA 94545
Phone (510) 300-3574

875 Geer Rd
Turlock, CA 95380
Phone (209) 633-0357

2111 Geer Rd
Ste 510
Turlock, CA 95382
Phone (209) 250-2315

Interoperability endpoints

  • Direct secure messaging: juan.perezlcsw.p1@direct.castle.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1730658683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 WADDELL WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953571487",
            "telephone_number": "209-585-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 GEER RD",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953803311",
            "telephone_number": "209-633-3031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3605 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Atwater",
            "state": "CA",
            "postal_code": "953015173",
            "country_code": "US",
            "telephone_number": "209-381-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JUAN",
        "middle_name": "MANUEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-21",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "82631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

Verify at the official NPI Registry.