Individual
DR. AGATHI GLEZAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD LCSW
Contact information
Practice address
27596 HOMESTEAD RD, LAGUNA NIGUEL, CA 92677-6602
(714) 642-1621
(562) 985-5514
Mailing address
27596 HOMESTEAD RD, LAGUNA NIGUEL, CA 92677-6602
(714) 642-1621
(562) 985-5514
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW5432
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007495215
AETNA
KY
05
—
CSW05432
—
CA
01
—
ZZZ83022Z
BLUE SHIELD OF CA
CA
Enumeration date
09/07/2006
Last updated
10/30/2023
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