Antonio Perez III, CADCIII B0011040519

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

B0011040519 Issued in CA

Practice address

1260 E Arrow Hwy
Upland, CA 91786-4982

Phone

(909) 981-2171

Fax

(909) 981-2031

NPI assigned

Aug 16, 2007

Last updated

May 11, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1811189483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 E ARROW HWY",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864982",
            "telephone_number": "909-981-2171",
            "fax_number": "909-981-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 E ARROW HWY",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864982",
            "telephone_number": "909-981-2171",
            "fax_number": "909-981-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ANTONIO",
        "name_suffix": "III",
        "credential": "CADCIII B0011040519",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-16",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "B0011040519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Penaloza
• Sergio Penunuri Jr., RN
• Gabriel Perdomo, MD
• Perez & Perez Medical Corp
• Andrew Perez, PT, DPT
• Carlos Perez, NP
• Cristina Angela Perez, MSN, RN, FNP
• Eduardo Perez
• Glenn Mendoza Perez, M.D.
• Lori Jean Perez, MSW STUDENT INTERN

• Addiction (Substance Use Disorder) Counselor in Upland, CA
• Providers in Upland, 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 May 11, 2022; 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.