Provider Demographics
NPI:1215203245
Name:DAVIS-PERKINS, MARIA
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:DAVIS-PERKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC, SP
Mailing Address - Street 1:8651 CAMINO LIMON RD
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-9252
Mailing Address - Country:US
Mailing Address - Phone:951-603-0955
Mailing Address - Fax:951-603-0955
Practice Address - Street 1:8651 CAMINO LIMON RD
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92883-9252
Practice Address - Country:US
Practice Address - Phone:951-603-0955
Practice Address - Fax:951-603-0955
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8222235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist