Provider Demographics
NPI:1750933297
Name:FLORES OLMEDO, CESAR ALEJANDRO
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:ALEJANDRO
Last Name:FLORES OLMEDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6660 WESTPARK PL
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-8801
Mailing Address - Country:US
Mailing Address - Phone:714-655-3354
Mailing Address - Fax:
Practice Address - Street 1:12395 LEWIS ST STE 202
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-4694
Practice Address - Country:US
Practice Address - Phone:714-867-6384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-15
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty