Healthcare Provider Details

I. General information

NPI: 1184502320
Provider Name (Legal Business Name): CHRISTEN JUNELLE DELA VEGA RELLES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 S HARBOR BLVD
ANAHEIM CA
92805-3700
US

IV. Provider business mailing address

PO BOX 2173
BALDWIN PARK CA
91706-1114
US

V. Phone/Fax

Practice location:
  • Phone: 714-517-6300
  • Fax:
Mailing address:
  • Phone: 626-278-1235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number138788
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: