Provider Demographics
NPI:1437821642
Name:VELAZQUEZ, AYLIN
Entity Type:Individual
Prefix:
First Name:AYLIN
Middle Name:
Last Name:VELAZQUEZ
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 1:5528 GOTHAM ST
Mailing Address - Street 2:
Mailing Address - City:BELL GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90201-5411
Mailing Address - Country:US
Mailing Address - Phone:323-384-6831
Mailing Address - Fax:
Practice Address - Street 1:5528 GOTHAM ST
Practice Address - Street 2:
Practice Address - City:BELL GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90201-5411
Practice Address - Country:US
Practice Address - Phone:323-384-6831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician