Individual
DR. AGLAED VERONICA MAYORGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
5665 WILSHIRE BLVD # 1267, LOS ANGELES, CA 90036-3710
(562) 250-4452
Mailing address
5665 WILSHIRE BLVD # 1267, LOS ANGELES, CA 90036-3710
(562) 250-4452
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
32765
CA
103TC0700X
Clinical Psychologist
32765
CA
103TF0000X
Family Psychologist
32765
CA
103TF0200X
Forensic Psychologist
32765
CA
103TF0200X
Forensic Psychologist
Primary
—
—
103TP2701X
Group Psychotherapy Psychologist
32765
CA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15483734
CAQH
CA
01
—
32765
PSY
CA
Enumeration date
04/05/2011
Last updated
11/26/2025
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