Provider Demographics
NPI:1043614639
Name:VALDIVIA, CECELIA (LMFT)
Entity Type:Individual
Prefix:
First Name:CECELIA
Middle Name:
Last Name:VALDIVIA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1188 N EUCLID ST # 500
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1900
Mailing Address - Country:US
Mailing Address - Phone:714-644-6480
Mailing Address - Fax:714-254-2974
Practice Address - Street 1:1188 N EUCLID ST # 500
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1900
Practice Address - Country:US
Practice Address - Phone:714-644-6480
Practice Address - Fax:714-254-2974
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-10
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF76131101YM0800X
CA115781106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health