Provider Demographics
NPI:1447392139
Name:VELASQUEZ, MONICA ELIZABETH (CCDC-CADAC)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:ELIZABETH
Last Name:VELASQUEZ
Suffix:
Gender:F
Credentials:CCDC-CADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 E COLORADO BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-6617
Mailing Address - Country:US
Mailing Address - Phone:626-577-2261
Mailing Address - Fax:626-577-2543
Practice Address - Street 1:2555 EAST COLORADO BLVD SUITE 100
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107
Practice Address - Country:US
Practice Address - Phone:626-577-2261
Practice Address - Fax:626-577-2543
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health