Provider Demographics
NPI:1336101153
Name:VELASQUEZ, CESAR PABLO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CESAR
Middle Name:PABLO
Last Name:VELASQUEZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3144 G ST # 125-268
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-1300
Mailing Address - Country:US
Mailing Address - Phone:209-726-1015
Mailing Address - Fax:209-385-3856
Practice Address - Street 1:875 GEER RD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-3311
Practice Address - Country:US
Practice Address - Phone:209-633-3057
Practice Address - Fax:209-385-3856
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS175751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS17575OtherLICENSE
CALCS17575OtherLICENSE