Provider Demographics
NPI:1720551278
Name:VELEZ, META LYNN (LPCC, LMFT)
Entity Type:Individual
Prefix:
First Name:META
Middle Name:LYNN
Last Name:VELEZ
Suffix:
Gender:F
Credentials:LPCC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751388
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94975-1388
Mailing Address - Country:US
Mailing Address - Phone:707-338-3092
Mailing Address - Fax:
Practice Address - Street 1:114 JAGLA ST
Practice Address - Street 2:
Practice Address - City:COTATI
Practice Address - State:CA
Practice Address - Zip Code:94931-5407
Practice Address - Country:US
Practice Address - Phone:707-338-3092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-08
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122785106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist