Provider Demographics
NPI:1639335136
Name:VELASQUEZ, CHRISTINE ARLEN
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ARLEN
Last Name:VELASQUEZ
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 1:7515 VAN NUYS BLVD
Mailing Address - Street 2:SUITE 461
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-1949
Mailing Address - Country:US
Mailing Address - Phone:818-659-5733
Mailing Address - Fax:818-947-4661
Practice Address - Street 1:7515 VAN NUYS BLVD
Practice Address - Street 2:SUITE 461
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-1949
Practice Address - Country:US
Practice Address - Phone:818-659-5733
Practice Address - Fax:818-947-4661
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical