Individual
MRS. ANGELA LAURIE PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
1834 UCCELLO AVE, MODESTO, CA 95354-2938
(510) 301-0407
Mailing address
1834 UCCELLO AVE, MODESTO, CA 95354-2938
(510) 301-0407
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
61191
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
01/27/2021
Last updated
01/27/2021
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