Provider Demographics
NPI:1972797728
Name:DELGADO, TERRY ANN
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:ANN
Last Name:DELGADO
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 1:500 THE CITY PARKWAY WEST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868
Mailing Address - Country:US
Mailing Address - Phone:714-834-7742
Mailing Address - Fax:714-834-8235
Practice Address - Street 1:500 THE CITY PARKWAY WEST
Practice Address - Street 2:SUITE 400
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868
Practice Address - Country:US
Practice Address - Phone:714-834-7742
Practice Address - Fax:714-834-8235
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty