Organization
IMPACTING KIDZ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSSY C PEREZ MS (BEHAVIOR ANALYST)
(626) 328-6929
Entity
Organization
Contact information
Practice address
24802 LAKEFIELD ST, LAKE FOREST, CA 92630-2425
(626) 328-6929
Mailing address
24802 LAKEFIELD ST, LAKE FOREST, CA 92630-2425
(626) 328-6929
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/12/2023
Last updated
04/12/2023
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