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1174266993
JUSTIN TENAMAXTLY PEREZ
LAKEPORT, CA
NPI
1174266993
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2022-04-19
Last Update Date
2025-01-08
Business Address
JUSTIN TENAMAXTLY PEREZ
150 S MAIN ST
LAKEPORT, CA 95453-5017
Phone number: 916-584-7800
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Mailing Address
JUSTIN TENAMAXTLY PEREZ
PO BOX 2077
UKIAH, CA 95482-2077
Phone number: 707-467-2010
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