Provider Demographics
NPI:1659548675
Name:DELGADO, XIOMARA ALICIA (LCSW)
Entity type:Individual
Prefix:MS
First Name:XIOMARA
Middle Name:ALICIA
Last Name:DELGADO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 QUAIL ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2730
Mailing Address - Country:US
Mailing Address - Phone:949-422-8009
Mailing Address - Fax:949-422-8009
Practice Address - Street 1:3115 RED HILL AVE
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4517
Practice Address - Country:US
Practice Address - Phone:714-850-8408
Practice Address - Fax:714-850-8587
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS15100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health