Provider Demographics
NPI:1740420850
Name:VELAZQUEZ, JANET HOPSON
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:HOPSON
Last Name:VELAZQUEZ
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 1:14550 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2210
Mailing Address - Country:US
Mailing Address - Phone:818-901-4879
Mailing Address - Fax:818-901-8985
Practice Address - Street 1:14550 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2210
Practice Address - Country:US
Practice Address - Phone:818-901-4879
Practice Address - Fax:818-901-8985
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112927225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7006Medicaid