Healthcare Provider Details

I. General information

NPI: 1114556487
Provider Name (Legal Business Name): LYMARIES VELEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 OAK RD STE 270
WALNUT CREEK CA
94597-2078
US

IV. Provider business mailing address

3100 OAK RD STE 270
WALNUT CREEK CA
94597-2078
US

V. Phone/Fax

Practice location:
  • Phone: 925-944-9711
  • Fax:
Mailing address:
  • Phone: 925-944-9711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA193441
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: