Individual provider Active NPI

Denise Velazquez

  • Mental Health Counselor
  • San Bernardino, CA
National Provider Identifier
1396342937
Registry record updated Mar 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
17881 Issued in CA
Practice address
780 E Gilbert St BLDG H
San Bernardino, CA 92415-5085
Phone
(909) 763-4760
NPI assigned
Oct 7, 2020
Last updated
Mar 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 17881 CA Primary
Behavior Technician 106S00000X Y3758975 CA

Addresses

Primary practice location

780 E Gilbert St BLDG H
San Bernardino, CA 92415-5085

Mailing address

1970 7TH St Apt 115
Riverside, CA 92507-4391
Phone (323) 831-4867

Other practice location 1

21600 Oxnard St Ste 1030
Woodland Hills, CA 91367-5085
Phone (323) 350-1358

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
Y3758975CAMDBehavior Technician
17881CAMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743206400000",
    "number": "1396342937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 7TH ST APT 115",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925074391",
            "telephone_number": "323-831-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 E GILBERT ST BLDG H",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924155085",
            "telephone_number": "909-763-4760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21600 Oxnard St Ste 1030",
            "address_purpose": "LOCATION",
            "city": "Woodland Hills",
            "state": "CA",
            "postal_code": "913675085",
            "country_code": "US",
            "telephone_number": "323-350-1358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "DENISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2025-03-29",
        "certification_date": "2025-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "17881",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "Y3758975",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.