Healthcare Provider Details

I. General information

NPI: 1750906756
Provider Name (Legal Business Name): EDILIA SAEZ VAZQUEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 06/27/2025
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24158 PASEO DEL RANCHO DR
VALENCIA CA
91354-2465
US

IV. Provider business mailing address

24158 PASEO DEL RANCHO DR
VALENCIA CA
91354-2465
US

V. Phone/Fax

Practice location:
  • Phone: 661-505-0023
  • Fax:
Mailing address:
  • Phone: 661-505-0023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW98914
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number127100
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: