Healthcare Provider Details

I. General information

NPI: 1851592406
Provider Name (Legal Business Name): MANUEL DELGADO MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10155 COLIMA RD
WHITTIER CA
90603
US

IV. Provider business mailing address

10155 COLIMA RD
WHITTIER CA
90603-2042
US

V. Phone/Fax

Practice location:
  • Phone: 562-692-0383
  • Fax: 562-692-0380
Mailing address:
  • Phone: 562-692-0383
  • Fax: 562-692-0380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number95407
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number64626
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number108137
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: