Divina Elise Perez, is a
Student In An Organized Health Care Education/training Program based in Norco, California. Divina Elise Perez is licensed to practice in NU (license number ) and her current practice location is
5th Street & Western, Norco, California. She can be reached at her office (for appointments etc.) via phone at
(951) 737-2683.
NPI number for Divina Elise Perez is 1053935353 and her current mailing address is 1511 E Hazeltine St, Ontario, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1053935353.
Healthcare Provider's Profile
| Full Name | Divina Elise Perez |
|---|
| Gender | Female |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 5th Street & Western, Norco, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1053935353
- Provider Enumeration Date: 06/02/2020
- Last Update Date: 08/19/2024
Medical Identifiers
Medical identifiers for Divina Elise Perez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1053935353 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (NU) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (NU) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Divina Elise Perez is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Divina Elise Perez,
1511 E Hazeltine St,
Ontario, CA 91761-7243
Ph: (909) 215-1216 | Divina Elise Perez,
5th Street & Western,
Norco, CA 92860
Ph: (951) 737-2683 |
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