Provider Demographics
NPI:1386445005
Name:PEREZ, GENEVIEVE A
Entity type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:A
Last Name:PEREZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 KRUGER AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-4042
Mailing Address - Country:US
Mailing Address - Phone:510-754-8644
Mailing Address - Fax:
Practice Address - Street 1:1260 KRUGER AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-4042
Practice Address - Country:US
Practice Address - Phone:510-754-8644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach