Most Relevant Information
Provider Data
| NPI Number: | 1003331190 |
| Provider Name: | SOFIA CASILLAS PEREA |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/09/2017 |
| Last Updated: | 12/22/2022 |
Provider Practice Location
330 MOSS ST
CHULA VISTA
CA
919112005
Practice Location Phone/Fax
| Phone: | 6193159263 |
| Fax: |
Provider Mailing Location
330 MOSS ST
CHULA VISTA
CA
919112005
Provider Mailing Phone/Fax
| Phone: | 6193159263 |
| Fax: |