Active NPI
Nicholas Jesus Perez, MD
- Child & Adolescent Psychiatry Physician
- San Diego, CA
National Provider Identifier
1922428622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- A148494
- Practice address
- 2351 Cardinal Lane
Annex B
San Diego, CA 92123 - Phone
- (858) 573-2227
- Fax
- (858) 496-2113
- NPI assigned
- Apr 21, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | A148494 | CA | Primary |
Addresses
Primary practice location
2351 Cardinal Lane
Annex B
San Diego, CA 92123
Mailing address
430 F St
Chula Vista, CA 91910-3711
Phone (619) 420-3620
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A148494 | CA | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664841600000",
"number": "1922428622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 F ST",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919103711",
"telephone_number": "619-420-3620",
"fax_number": "619-420-8722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2351 CARDINAL LANE",
"address_2": "ANNEX B",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92123",
"telephone_number": "858-573-2227",
"fax_number": "858-496-2113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "NICHOLAS",
"middle_name": "JESUS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-04-21",
"last_updated": "2022-10-04",
"certification_date": "2022-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "A148494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.