Provider Demographics
NPI:1427457076
Name:PEREZ, YESENIA
Entity type:Individual
Prefix:MS
First Name:YESENIA
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 1:1640 E FLAMINGO RD
Mailing Address - Street 2:#100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5249
Mailing Address - Country:US
Mailing Address - Phone:702-369-4357
Mailing Address - Fax:702-369-4089
Practice Address - Street 1:1640 E FLAMINGO RD
Practice Address - Street 2:#100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5249
Practice Address - Country:US
Practice Address - Phone:702-369-4357
Practice Address - Fax:702-369-4089
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner