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Individual

SOLOMON EZEKIEL PEREZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
B.A

Contact information

Practice address
3539 COLLEGE AVE, SAN DIEGO, CA 92115-7032
(619) 818-3788
Mailing address
1031 25TH ST, SAN DIEGO, CA 92102-2102
(619) 232-6454

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CA
175T00000X
Peer Specialist
Primary
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3704
CA
Enumeration date
10/16/2017
Last updated
01/26/2022
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