Individual
WENDELL JOHN VELASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
18111 NORDHOFF ST, NORTHRIDGE, CA 91330
(510) 258-2700
Mailing address
1620 BANDONI AVE, SAN LORENZO, CA 94580-2104
(510) 258-2700
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/22/2017
Last updated
07/26/2018
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