Provider Demographics
NPI:1225539836
Name:FARWELL, VALETTE
Entity Type:Individual
Prefix:MS
First Name:VALETTE
Middle Name:
Last Name:FARWELL
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 1:2277 GOSHEN AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-8104
Mailing Address - Country:US
Mailing Address - Phone:559-321-1309
Mailing Address - Fax:
Practice Address - Street 1:916 WATERMAN AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-3762
Practice Address - Country:US
Practice Address - Phone:559-323-4469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)