Provider Demographics
NPI:1073860987
Name:VALDERRAMA, ISABELLE
Entity Type:Individual
Prefix:MS
First Name:ISABELLE
Middle Name:
Last Name:VALDERRAMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 HARBOR BLVD.
Mailing Address - Street 2:BUILDING E
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-4047
Mailing Address - Country:US
Mailing Address - Phone:650-802-6538
Mailing Address - Fax:650-802-6440
Practice Address - Street 1:400 HARBOR BLVD
Practice Address - Street 2:BUILDING E
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-4047
Practice Address - Country:US
Practice Address - Phone:650-802-6538
Practice Address - Fax:650-802-6440
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst