Provider Demographics
NPI:1508748856
Name:PEREZ, GRACE (RDN, CLC)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:RDN, CLC
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2907 W LONG CIR APT C
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4352
Mailing Address - Country:US
Mailing Address - Phone:720-244-0671
Mailing Address - Fax:
Practice Address - Street 1:2907 W LONG CIR APT C
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4352
Practice Address - Country:US
Practice Address - Phone:720-244-0671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO317460174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist