Provider Demographics
NPI:1073877809
Name:VELASQUEZ-RODRIQUEZ, ANNA XOCHILT (IMF)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:XOCHILT
Last Name:VELASQUEZ-RODRIQUEZ
Suffix:
Gender:F
Credentials:IMF
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:VELASQUEZ-RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21520 PIONEER BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:HAWAIIAN GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90716-2604
Mailing Address - Country:US
Mailing Address - Phone:562-865-3644
Mailing Address - Fax:562-865-5244
Practice Address - Street 1:21520 PIONEER BLVD STE 110
Practice Address - Street 2:
Practice Address - City:HAWAIIAN GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90716-2604
Practice Address - Country:US
Practice Address - Phone:562-865-3644
Practice Address - Fax:562-865-5244
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF70577106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist