Provider Demographics
NPI:1134551484
Name:VELASQUEZ, MARTHA E (IMFT)
Entity type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:E
Last Name:VELASQUEZ
Suffix:
Gender:F
Credentials:IMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 PAINTER AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-2505
Mailing Address - Country:US
Mailing Address - Phone:560-903-7000
Mailing Address - Fax:
Practice Address - Street 1:7208 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:BELL GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90201-4812
Practice Address - Country:US
Practice Address - Phone:323-407-8011
Practice Address - Fax:323-426-2870
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT145625106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist