Provider Demographics
NPI:1154636835
Name:SYDNOR, VALERIE JANE (LCSW)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:JANE
Last Name:SYDNOR
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 1:490 LAKE PARK AVE UNIT 10805
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-8030
Mailing Address - Country:US
Mailing Address - Phone:610-906-6725
Mailing Address - Fax:
Practice Address - Street 1:424 STANTON AVE #105
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610
Practice Address - Country:US
Practice Address - Phone:610-906-6725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA793881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical