Provider Demographics
NPI:1093277600
Name:VALDEMAR, JASON (AMFT137598)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:VALDEMAR
Suffix:
Gender:M
Credentials:AMFT137598
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21545 CENTRE POINTE PKWY
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-2947
Mailing Address - Country:US
Mailing Address - Phone:661-259-9439
Mailing Address - Fax:661-259-9658
Practice Address - Street 1:21545 CENTRE POINTE PKWY
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-2947
Practice Address - Country:US
Practice Address - Phone:661-259-9439
Practice Address - Fax:661-259-9658
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT137598101YM0800X, 106H00000X
CAAPCC3738101YP2500X
CAAMFT97925106H00000X
CALMFT140646106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional