Most Relevant Information
Provider Data
| NPI Number: | 1003396201 |
| Provider Name: | BALDIVENIA PEREZ |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/16/2018 |
| Last Updated: | 08/16/2018 |
Provider Practice Location
1000 BROADWAY STE 100
EL CAJON
CA
920214899
Practice Location Phone/Fax
| Phone: | 6194015424 |
| Fax: |
Provider Mailing Location
3756 40TH ST
SAN DIEGO
CA
921052422
Provider Mailing Phone/Fax
| Phone: | 6197249444 |
| Fax: |