Provider Demographics
NPI:1245485028
Name:VELASCO, MARGARITA
Entity type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:VELASCO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1191 CENTRAL BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-2253
Mailing Address - Country:US
Mailing Address - Phone:925-698-2364
Mailing Address - Fax:
Practice Address - Street 1:2335 COUNTRY HILLS DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-7319
Practice Address - Country:US
Practice Address - Phone:925-608-8735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No171M00000XOther Service ProvidersCase Manager/Care Coordinator