Provider Demographics
NPI:1790663243
Name:DE LA GARZA, VICTORIA ANNE (LMFT)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ANNE
Last Name:DE LA GARZA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10860 FULLBRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-1737
Mailing Address - Country:US
Mailing Address - Phone:909-230-1416
Mailing Address - Fax:
Practice Address - Street 1:10860 FULLBRIGHT AVE
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-1737
Practice Address - Country:US
Practice Address - Phone:909-230-1416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA155904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist