Provider Demographics
NPI:1689853913
Name:GALLEGOS-LOZANO, VERONICA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:
Last Name:GALLEGOS-LOZANO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 NE 43RD AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-1335
Mailing Address - Country:US
Mailing Address - Phone:503-709-2605
Mailing Address - Fax:503-295-7337
Practice Address - Street 1:2875 NE STUCKI AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5806
Practice Address - Country:US
Practice Address - Phone:971-310-4522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR38511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical