Provider Demographics
NPI:1407193667
Name:VALLADARES, ADA M (MSW)
Entity Type:Individual
Prefix:MISS
First Name:ADA
Middle Name:M
Last Name:VALLADARES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 W 3RD ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-1993
Mailing Address - Country:US
Mailing Address - Phone:323-629-7066
Mailing Address - Fax:
Practice Address - Street 1:2100 W 3RD ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-1944
Practice Address - Country:US
Practice Address - Phone:323-269-7066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79279101YM0800X
CA33817101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health