Provider Demographics
NPI:1831385616
Name:ORELLANA, VERONICA RUBY (MA, MFT INTERN)
Entity type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:RUBY
Last Name:ORELLANA
Suffix:
Gender:F
Credentials:MA, MFT INTERN
Other - Prefix:MS
Other - First Name:VERONICA
Other - Middle Name:RUBY
Other - Last Name:CARDENAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, MFT-INTERN
Mailing Address - Street 1:9280 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-2501
Mailing Address - Country:US
Mailing Address - Phone:323-983-3270
Mailing Address - Fax:
Practice Address - Street 1:1000 CORPORATE CENTER DR STE 650
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754
Practice Address - Country:US
Practice Address - Phone:626-957-8442
Practice Address - Fax:626-266-5780
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-14
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 54874106H00000X
CAIMF76653106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist