Provider Demographics
NPI:1053500538
Name:PEREZ, RENE C
Entity type:Individual
Prefix:MR
First Name:RENE
Middle Name:C
Last Name:PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:PROF
Other - First Name:RENE
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1901 HEARST AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-2127
Mailing Address - Country:US
Mailing Address - Phone:510-981-5192
Mailing Address - Fax:
Practice Address - Street 1:1901 HEARST AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94709-2127
Practice Address - Country:US
Practice Address - Phone:510-981-5192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator