MEDICARE: DENNIS DELA FUENTE

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	579061	CA

General Provider Information

NPI Number	:	1851254221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNIS DELA FUENTE

Provider Business Mailing Address
First Line	:	2413 ESTHER VIEW DR
Second Line	:
City	:	LOMITA
State	:	CA
Zip	:	90717-2312
Country	:	US
Telephone Number	:	310-626-2662
Fax Number	:

Provider Business Practice Location Address
First Line	:	2413 ESTHER VIEW DR
Second Line	:
City	:	LOMITA
State	:	CA
Zip	:	90717-2312
Country	:	US
Telephone Number	:	310-626-2662
Fax Number	:

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

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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Directions to “ DENNIS DELA FUENTE ” Practice Location

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