Individual
JORGE JOSEPH PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
840 N AVENUE 66, LOS ANGELES, CA 90042-1508
(626) 395-7100
Mailing address
840 N AVENUE 66, LOS ANGELES, CA 90042-1508
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
10482
CA
101YP2500X
Professional Counselor
Primary
10482
CA
225400000X
Rehabilitation Practitioner
10482
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDICAL
CA
Enumeration date
07/16/2018
Last updated
04/10/2025
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