Provider Demographics
NPI:1316064207
Name:PEREZ, JASON SANCHEZ (CAS)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:SANCHEZ
Last Name:PEREZ
Suffix:
Gender:M
Credentials:CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 37TH AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-4324
Mailing Address - Country:US
Mailing Address - Phone:209-505-9644
Mailing Address - Fax:
Practice Address - Street 1:225 37TH AVENUE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403
Practice Address - Country:US
Practice Address - Phone:209-505-9644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)