Provider Demographics
NPI:1487840369
Name:GALVEZ-NELSON, NOELIA REBECA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NOELIA
Middle Name:REBECA
Last Name:GALVEZ-NELSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:27261 LAS RAMBLAS
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6441
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34324 YUCAIPA BLVD
Practice Address - Street 2:SUITE B-D
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-2496
Practice Address - Country:US
Practice Address - Phone:909-790-1300
Practice Address - Fax:909-797-9687
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CALCSW711741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33854Medicaid