Healthcare Provider Details

I. General information

NPI: 1497399265
Provider Name (Legal Business Name): JOANNA MARIE DELGADO ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2019
Last Update Date: 07/07/2023
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13001 RAMONA BLVD STE 1
IRWINDALE CA
91706-3752
US

IV. Provider business mailing address

PO BOX 545
BALDWIN PARK CA
91706-0545
US

V. Phone/Fax

Practice location:
  • Phone: 626-337-3828
  • Fax:
Mailing address:
  • Phone: 626-422-6199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number90688
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW111864
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: