Provider Demographics
NPI:1750260956
Name:PERAZA, DESIRE MARIE
Entity type:Individual
Prefix:
First Name:DESIRE
Middle Name:MARIE
Last Name:PERAZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41769 11TH ST W STE A
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-1418
Mailing Address - Country:US
Mailing Address - Phone:661-947-9554
Mailing Address - Fax:
Practice Address - Street 1:39406 CHALFONT LN
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1061
Practice Address - Country:US
Practice Address - Phone:818-636-6677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-01
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician