Healthcare Provider Details

I. General information

NPI: 1134551484
Provider Name (Legal Business Name): MARTHA E. VELASQUEZ IMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2013
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7208 GARFIELD AVE
BELL GARDENS CA
90201-4812
US

IV. Provider business mailing address

8000 PAINTER AVE
WHITTIER CA
90602-2505
US

V. Phone/Fax

Practice location:
  • Phone: 323-407-8011
  • Fax: 323-426-2870
Mailing address:
  • Phone: 560-903-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT145625
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: