Provider Demographics
NPI:1114718806
Name:PEREZ DELGADO, JERRY
Entity type:Individual
Prefix:
First Name:JERRY
Middle Name:
Last Name:PEREZ DELGADO
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 1:11876 STUART DR APT 4
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-1656
Mailing Address - Country:US
Mailing Address - Phone:657-656-2842
Mailing Address - Fax:
Practice Address - Street 1:13222 CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-4414
Practice Address - Country:US
Practice Address - Phone:855-588-1422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)