Healthcare Provider Details

I. General information

NPI: 1801564661
Provider Name (Legal Business Name): VICTORIA VASQUEZ ANDRADE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2021
Last Update Date: 06/28/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 UVALDA ST UNIT 348
AURORA CO
80011-6481
US

IV. Provider business mailing address

1380 UVALDA ST UNIT 348
AURORA CO
80011-6481
US

V. Phone/Fax

Practice location:
  • Phone: 318-464-5290
  • Fax:
Mailing address:
  • Phone: 318-464-5290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC24930
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number089.0136568
License Number StateVT
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14334
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09931634
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: