Healthcare Provider Details

I. General information

NPI: 1821118092
Provider Name (Legal Business Name): DR. VERONICA LORENA MACIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VERONICA LORENA MACIAS VERONICA SALAZAR

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12204 HONOLULU TER
WHITTIER CA
90601-2323
US

IV. Provider business mailing address

20101 HAMILTON AVE STE 155
TORRANCE CA
90502-1314
US

V. Phone/Fax

Practice location:
  • Phone: 213-220-6160
  • Fax:
Mailing address:
  • Phone: 424-369-4212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY24381
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: