Provider Demographics
NPI:1386010304
Name:VALENZUELA, CARVEL ALAN
Entity Type:Individual
Prefix:MR
First Name:CARVEL
Middle Name:ALAN
Last Name:VALENZUELA
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:CHARVEL
Other - Middle Name:ALAN
Other - Last Name:VALENZUELA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3727 W 6TH ST SUITE 402
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-5105
Mailing Address - Country:US
Mailing Address - Phone:213-365-7400
Mailing Address - Fax:
Practice Address - Street 1:3727 W 6TH ST SUITE 402
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-5105
Practice Address - Country:US
Practice Address - Phone:213-365-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW717481041C0700X
CALCSW934731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical