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General NPI Number Information
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NPI Number | 1609203959
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Entity Type | Individual
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Provider Name | HAZELL TERCERO-VELASQUEZ
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Gender | Female
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Dates
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Enumeration Date | 10/01/2013
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 13330 VAUGHN ST
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City | SAN FERNANDO
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State | CA
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Zip | 91340-2216
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Country | US
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Telephone | 310-451-9747
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Fax |
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Provider Business Mailing Address
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Address Line | 13330 VAUGHN ST
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City | SAN FERNANDO
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State | CA
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Zip | 91340-2216
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW76055
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | LCSW76055
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License Number State | CA
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