1003105123 NPI number — MRS. MONICA J PEREZ DE ARGUMANIZ B.A., SLP-A

Table of content: DR. DEBORAH L DYKEMA DO (NPI 1215097571)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003105123 NPI number — MRS. MONICA J PEREZ DE ARGUMANIZ B.A., SLP-A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PEREZ DE ARGUMANIZ
Provider First Name:
MONICA
Provider Middle Name:
J
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
B.A., SLP-A
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PEREZ DE ARGUMANIZ
Provider Other First Name:
MONICA
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
B.A., SLP-A
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1003105123
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12407 ASPENVIEW CIRCLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VICTORVILLE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92392
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
213-210-6942
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16785 BEAR VALLEY RD
Provider Second Line Business Practice Location Address:
#2
Provider Business Practice Location Address City Name:
HESPERIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92345-0825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-948-0702
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/29/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2355S0801X , with the licence number: 711A , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0197503 . This is a "DEPARTMENT OF SOCIAL SERVICES AND DISABILITY DETERMINATION SERVICE VENDOR NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 711A . This is a "ASHA SLPA LICENCE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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