Healthcare Provider Details

I. General information

NPI: 1518594191
Provider Name (Legal Business Name): SARAI VELASQUEZ LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 BEAUMONT AVE STE A2-142
BEAUMONT CA
92223-6820
US

IV. Provider business mailing address

1440 BEAUMONT AVE STE A2-142
BEAUMONT CA
92223-6820
US

V. Phone/Fax

Practice location:
  • Phone: 909-231-9862
  • Fax:
Mailing address:
  • Phone: 909-231-9862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number22250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: