MEDICARE: EDILIA SAEZ VAZQUEZ LCSW

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
1	101YM0800X	Mental Health Counselor	ASW98914	CA
2	171M00000X	Case Manager/Care Coordinator
3	1041C0700X	Clinical Social Worker	127100	CA

General Provider Information

NPI Number	:	1750906756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDILIA SAEZ VAZQUEZ LCSW

Provider Business Mailing Address
First Line	:	24158 PASEO DEL RANCHO DR
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91354-2465
Country	:	US
Telephone Number	:	661-505-0023
Fax Number	:

Provider Business Practice Location Address
First Line	:	24158 PASEO DEL RANCHO DR
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91354-2465
Country	:	US
Telephone Number	:	661-505-0023
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2020
Last Update Date	:	06/27/2025

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