Provider Demographics
NPI:1326558453
Name:STAPLES-FOSTER, VELMA GWENDOLYN (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:VELMA
Middle Name:GWENDOLYN
Last Name:STAPLES-FOSTER
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24355 CREEKSIDE RD UNIT 800616
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91380-7048
Mailing Address - Country:US
Mailing Address - Phone:626-346-9481
Mailing Address - Fax:
Practice Address - Street 1:25050 AVENUE KEARNY STE 215
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1257
Practice Address - Country:US
Practice Address - Phone:323-879-9176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT109963101YM0800X
101YP1600X
CA127905106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral