Provider Demographics
NPI:1730260928
Name:PEREZ, ALICIA (DPT)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2447 SANTA CLARA AVE
Mailing Address - Street 2:SUITE # 205
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4575
Mailing Address - Country:US
Mailing Address - Phone:510-521-3746
Mailing Address - Fax:510-521-3745
Practice Address - Street 1:2447 SANTA CLARA AVE
Practice Address - Street 2:SUITE # 205
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4575
Practice Address - Country:US
Practice Address - Phone:510-521-3746
Practice Address - Fax:510-521-3745
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17281225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT172810Medicare PIN