Provider Demographics
NPI:1053532374
Name:PEREZ, ROSA OFELIA (LCSW)
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:OFELIA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROSA
Other - Middle Name:OFELIA
Other - Last Name:COBARRUVIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, MSW
Mailing Address - Street 1:5441 E MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-3325
Mailing Address - Country:US
Mailing Address - Phone:559-940-4749
Mailing Address - Fax:
Practice Address - Street 1:3636 N 1ST ST STE 112
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-6818
Practice Address - Country:US
Practice Address - Phone:855-343-1057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical