Healthcare Provider Details

I. General information

NPI: 1487250551
Provider Name (Legal Business Name): DENISE N DELGADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date: 09/03/2024
Reactivation Date: 10/01/2024

III. Provider practice location address

23990 EUCALYPTUS AVE
MORENO VALLEY CA
92553-5504
US

IV. Provider business mailing address

23990 EUCALYPTUS AVE
MORENO VALLEY CA
92553-5504
US

V. Phone/Fax

Practice location:
  • Phone: 951-571-4710
  • Fax:
Mailing address:
  • Phone: 951-571-4710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: