Provider Demographics
NPI:1841543642
Name:LOMELI, MABEL (LCSW115844)
Entity type:Individual
Prefix:
First Name:MABEL
Middle Name:
Last Name:LOMELI
Suffix:
Gender:F
Credentials:LCSW115844
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11731 TELEGRAPH RD STE K
Mailing Address - Street 2:
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-6821
Mailing Address - Country:US
Mailing Address - Phone:562-942-8256
Mailing Address - Fax:562-949-3587
Practice Address - Street 1:11731 TELEGRAPH RD STE E
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670
Practice Address - Country:US
Practice Address - Phone:562-942-8256
Practice Address - Fax:562-949-3587
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2023-06-26
Deactivation Date:2018-07-31
Deactivation Code:
Reactivation Date:2018-08-08
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
CAASW84087101YM0800X
LCSW1158441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health