Provider Demographics
NPI:1942904701
Name:PEREZ, KAREN MARISOL
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MARISOL
Last Name:PEREZ
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 1:1820 W ORANGEWOOD AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-5056
Mailing Address - Country:US
Mailing Address - Phone:714-696-2862
Mailing Address - Fax:714-242-9308
Practice Address - Street 1:800 S HARBOR BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-5188
Practice Address - Country:US
Practice Address - Phone:714-471-7207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant