Provider Demographics
NPI:1275868358
Name:VELASQUEZ ORELLANA, ANY M (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:ANY
Middle Name:M
Last Name:VELASQUEZ ORELLANA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12821 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3012
Mailing Address - Country:US
Mailing Address - Phone:818-432-5025
Mailing Address - Fax:818-432-0872
Practice Address - Street 1:12821 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3012
Practice Address - Country:US
Practice Address - Phone:818-432-5025
Practice Address - Fax:818-432-0872
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW893181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical