Individual
NICOLE D PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12019 SYCAMORE ST APT 1, NORWALK, CA 90650-4139
(559) 317-4766
Mailing address
12019 SYCAMORE ST APT 1, NORWALK, CA 90650-4139
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
242514
BOC
—
Enumeration date
02/13/2018
Last updated
02/13/2018
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