Provider Demographics
NPI:1609188374
Name:DELLING, LETICIA JULIETTE (LMFT)
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:JULIETTE
Last Name:DELLING
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3855 ALAMO ST STE A
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-2104
Mailing Address - Country:US
Mailing Address - Phone:855-701-7955
Mailing Address - Fax:
Practice Address - Street 1:3855 ALAMO ST STE A
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2104
Practice Address - Country:US
Practice Address - Phone:855-701-7955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86712106H00000X
CA86712106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA86712OtherBOARD OF BEHAVIORAL SCIENCES