Provider Demographics
NPI:1821118092
Name:MACIAS, VERONICA LORENA
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:LORENA
Last Name:MACIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:VERONICA
Other - Middle Name:LORENA
Other - Last Name:MACIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:VERONICA SALAZAR
Mailing Address - Street 1:20101 HAMILTON AVE STE 155
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-1314
Mailing Address - Country:US
Mailing Address - Phone:424-369-4212
Mailing Address - Fax:
Practice Address - Street 1:12204 HONOLULU TER
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-2323
Practice Address - Country:US
Practice Address - Phone:213-220-6160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 225400000X, 225C00000X
CAPSY24381103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor