Healthcare Provider Details

I. General information

NPI: 1649830670
Provider Name (Legal Business Name): MARIA ALEJANDRA YEPEZ PALOMO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2019
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24953 PASEO DE VALENCIA BUILDING B SUIT 1B
LAGUNA HILLS CA
92653
US

IV. Provider business mailing address

24953 PASEO DE VALENCIA BUILDING B SUIT 1B
LAGUNA HILLS CA
92653
US

V. Phone/Fax

Practice location:
  • Phone: 949-540-0170
  • Fax: 949-540-0173
Mailing address:
  • Phone: 949-540-0170
  • Fax: 949-540-0173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number125751
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: