Individual
GLICELDA VELASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
233 E WEDDELL DR STE A, SUNNYVALE, CA 94089-1659
(510) 766-4060
Mailing address
31380 SAN ANDREAS DR, UNION CITY, CA 94587-2859
(408) 203-8421
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
624603
CA
363L00000X
Nurse Practitioner
95010659
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95010659
CA
Other
Enumeration date
06/30/2016
Last updated
01/23/2021
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