Provider Demographics
NPI:1417681966
Name:VELASQUEZ, NATALIA ANDREA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NATALIA
Middle Name:ANDREA
Last Name:VELASQUEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 VAN NESS AVE APT 205
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1237
Mailing Address - Country:US
Mailing Address - Phone:321-272-8088
Mailing Address - Fax:
Practice Address - Street 1:3700 N WILLIAMS AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1441
Practice Address - Country:US
Practice Address - Phone:503-281-4852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health