Provider Demographics
NPI:1811541006
Name:PEREZ, JONATHAN JEZER
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:JEZER
Last Name:PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 UNIVERSITY AVE, SOM ED. BLDG. II
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92521
Mailing Address - Country:US
Mailing Address - Phone:951-827-4618
Mailing Address - Fax:951-263-7238
Practice Address - Street 1:900 UNIVERSITY AVE, SOM ED. BLDG. II
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92521
Practice Address - Country:US
Practice Address - Phone:951-827-4618
Practice Address - Fax:951-263-7238
Is Sole Proprietor?:No
Enumeration Date:2019-07-26
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health