Provider Demographics
NPI:1013896893
Name:PERDE, ANAMARIE (WELLNESS COACH)
Entity type:Individual
Prefix:
First Name:ANAMARIE
Middle Name:
Last Name:PERDE
Suffix:
Gender:F
Credentials:WELLNESS COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 W BROOKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CHERRY VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92223-4073
Mailing Address - Country:US
Mailing Address - Phone:909-446-5547
Mailing Address - Fax:
Practice Address - Street 1:350 W BROOKSIDE AVE
Practice Address - Street 2:
Practice Address - City:CHERRY VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92223-4073
Practice Address - Country:US
Practice Address - Phone:909-446-5547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA648FA938C5171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach