Provider Demographics
NPI:1790599363
Name:PARKER, DELNICE ELIZABETH (PSYCHOLOGICAL ASSC)
Entity type:Individual
Prefix:
First Name:DELNICE
Middle Name:ELIZABETH
Last Name:PARKER
Suffix:
Gender:F
Credentials:PSYCHOLOGICAL ASSC
Other - Prefix:
Other - First Name:NEECIE
Other - Middle Name:
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4654 E AVENUE S # B264
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93552-4454
Mailing Address - Country:US
Mailing Address - Phone:323-646-0694
Mailing Address - Fax:
Practice Address - Street 1:3200 E GUASTI RD STE 141
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-8660
Practice Address - Country:US
Practice Address - Phone:909-757-4335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAPENDING101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty