Healthcare Provider Details

I. General information

NPI: 1114524105
Provider Name (Legal Business Name): DENISE NUNEZ VELASCO AMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2020
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27640 ENCANTO DR STE B
MENIFEE CA
92586-4542
US

IV. Provider business mailing address

1455 S STATE ST SPC 349
HEMET CA
92543-7617
US

V. Phone/Fax

Practice location:
  • Phone: 951-972-6262
  • Fax:
Mailing address:
  • Phone: 951-834-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT162548
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: