Provider Demographics
NPI:1538428719
Name:ORNELAS, IRENE VARELA (LCSW)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:VARELA
Last Name:ORNELAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6943
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91359-6943
Mailing Address - Country:US
Mailing Address - Phone:805-844-6369
Mailing Address - Fax:
Practice Address - Street 1:143 TRIUNFO CANYON RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2514
Practice Address - Country:US
Practice Address - Phone:805-777-1133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-09
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAASW #29412OtherCA BOARD OF BEHAVIORAL SCIENCES
CALCSW 60793OtherCALIFORNIA BOARD OF BEHAVIORAL SCIENCES