Provider Demographics
NPI:1538801246
Name:PEREA, DANIEL EDDIE
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:EDDIE
Last Name:PEREA
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 1:5015 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-4127
Mailing Address - Country:US
Mailing Address - Phone:323-653-1677
Mailing Address - Fax:
Practice Address - Street 1:5647 NORWALK BLVD APT 4
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-2530
Practice Address - Country:US
Practice Address - Phone:323-653-1677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)