Basic Information
| Provider Information | |||||||||
| NPI: | 1437709623 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VELA | ||||||||
| FirstName: | VICTORIA LEIGH ANNE | ||||||||
| MiddleName: | |||||||||
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| Credential: | AMFT/APCC | ||||||||
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| OtherLastName: | VELA | ||||||||
| OtherFirstName: | VICTORIA | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 13905 MILTON AVENUE SUITE #306 | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926837846 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7147931290 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 13950 MILTON AVE STE 306 | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926832939 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7147931290 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2019 | ||||||||
| LastUpdateDate: | 06/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 11421 | CA | N | Behavioral Health & Social Service Providers | Counselor | Professional | 106H00000X | 131224 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.