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NPI Code Detail

MEDICARE: CARLOS R VELASCO LPCC

MEDICARE: CARLOS R VELASCO LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor5800CA
2101YM0800XMental Health Counselor5800CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LPCC5800OTHERCABOARD OF BEHAVIOR SCIENCES

General Provider Information

NPI Number : 1528460508
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLOS R VELASCO LPCC
Provider Business Mailing Address
First Line : PO BOX 291083
Second Line :
City : LOS ANGELES
State : CA
Zip : 90029-9083
Country : US
Telephone Number : 424-309-2641
Fax Number :
Provider Business Practice Location Address
First Line : 225 W BROADWAY STE 155
Second Line :
City : GLENDALE
State : CA
Zip : 91204-1332
Country : US
Telephone Number : 818-441-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2014
Last Update Date : 03/03/2026

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Directions to “ CARLOS R VELASCO LPCC” Practice Location

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