Provider Demographics
NPI:1154291573
Name:PERIALES, AMELIA
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:PERIALES
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 1:1530 E 14TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-4943
Mailing Address - Country:US
Mailing Address - Phone:619-392-9331
Mailing Address - Fax:
Practice Address - Street 1:1530 E 14TH ST APT 2
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-4943
Practice Address - Country:US
Practice Address - Phone:619-392-9331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-10
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider