Individual
MRS. EDNA LARISSA VELAZQUEZ-WOLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2772 4TH AVE, 2ND FLOOR, SAN DIEGO, CA 92103-6206
(619) 295-6067
Mailing address
2772 4TH AVE, 2ND FLOOR, SAN DIEGO, CA 92103-6206
(619) 295-6067
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
01/09/2009
Last updated
01/23/2013
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