Provider Demographics
NPI:1710058391
Name:VELOZ, GINELLE JOY (AUD)
Entity Type:Individual
Prefix:
First Name:GINELLE
Middle Name:JOY
Last Name:VELOZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:GINELLE
Other - Middle Name:JOY
Other - Last Name:NEWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:23861 MCBEAN PKWY STE D14
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2003
Mailing Address - Country:US
Mailing Address - Phone:661-388-4135
Mailing Address - Fax:661-593-6105
Practice Address - Street 1:23861 MCBEAN PKWY STE D14
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2003
Practice Address - Country:US
Practice Address - Phone:661-388-4135
Practice Address - Fax:661-593-6105
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2090237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU2090OtherSTATE AUDIOLOGY LICENSE