Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jerricson Barlis Peralta, IDC

Individual provider Independent Duty Corpsman · NPI 1740719814

Jerricson Barlis Peralta, IDC is an Independent Duty Corpsman in Kittery, Maine. Registered with an NPI since 2017.

In the registry since
2017

Practice location Address checks out

402 Goodrich Ave
Kittery, ME 03904
Phone: (207) 438-1781
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X

Record details

NPI number1740719814
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorNo
NPI enumeratedJune 12, 2017
Last updated in NPPESJanuary 27, 2025
Certification dateJanuary 27, 2025
Mailing address6850 Mission Gorge Rd Apt 1248, San Diego, CA 92120-2478

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