Provider Demographics
NPI:1538454616
Name:DELGADO, COSETTE CRISTINA (ASW)
Entity type:Individual
Prefix:
First Name:COSETTE
Middle Name:CRISTINA
Last Name:DELGADO
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 W J ST
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-3045
Mailing Address - Country:US
Mailing Address - Phone:650-814-3204
Mailing Address - Fax:
Practice Address - Street 1:470 CHADBOURNE RD
Practice Address - Street 2:SUITE F
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-9600
Practice Address - Country:US
Practice Address - Phone:707-425-9670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW21979101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health