Provider Demographics
NPI:1366031189
Name:DELGADILLO, WENDELINE
Entity Type:Individual
Prefix:
First Name:WENDELINE
Middle Name:
Last Name:DELGADILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8228 MILLERGROVE DR
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-3026
Mailing Address - Country:US
Mailing Address - Phone:562-397-9338
Mailing Address - Fax:
Practice Address - Street 1:2001 E 4TH ST STE 200
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3916
Practice Address - Country:US
Practice Address - Phone:714-824-8140
Practice Address - Fax:714-824-8141
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health