Provider Demographics
NPI:1104514397
Name:PEREZ, YANET
Entity type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 FAIRMONT PKWY APT 2507
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-3322
Mailing Address - Country:US
Mailing Address - Phone:512-299-6820
Mailing Address - Fax:
Practice Address - Street 1:4201 FAIRMONT PKWY APT 2507
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-3322
Practice Address - Country:US
Practice Address - Phone:512-299-6820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician