Thomas Frank Velasquez Sr., R.T.
Individual provider Active NPI Counselor · S.L.O, CA
NPI 1922413244 · NPPES record last updated Oct 31, 2014
Key facts
- NPI
- 1922413244
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 2178 Johnson Ave.
S.L.O, CA 93401 - Phone
- (805) 781-4711
- NPI assigned
- Jun 25, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
2178 Johnson Ave.
S.L.O, CA 93401
Mailing address
9305 Carmalita Ave.
Atascadero, CA 93422
Phone (805) 466-2762
Other providers in S.L.O, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.