Provider Demographics
NPI:1427518893
Name:VELUZ, MARICEL
Entity type:Individual
Prefix:
First Name:MARICEL
Middle Name:
Last Name:VELUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 E ORANGE GROVE BLVD APT 313
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-3066
Mailing Address - Country:US
Mailing Address - Phone:626-584-6795
Mailing Address - Fax:
Practice Address - Street 1:595 E COLORADO BLVD STE 612B
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2015
Practice Address - Country:US
Practice Address - Phone:626-667-4717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-22
Last Update Date:2019-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA829501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty