Provider Demographics
NPI:1285231654
Name:VALENCIA-NGO, NELLA (LMFT)
Entity Type:Individual
Prefix:
First Name:NELLA
Middle Name:
Last Name:VALENCIA-NGO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:NELLA
Other - Middle Name:M
Other - Last Name:VALENCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:2021 E GLADSTONE ST STE K
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-5383
Mailing Address - Country:US
Mailing Address - Phone:626-627-0620
Mailing Address - Fax:
Practice Address - Street 1:2880 COCHRAN ST # 1009
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-0700
Practice Address - Country:US
Practice Address - Phone:626-627-0620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT84913106H00000X
CA84913106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist