Provider Demographics
NPI:1437678307
Name:VALADEZ-LOGAN, CARLEY (MSW)
Entity Type:Individual
Prefix:MRS
First Name:CARLEY
Middle Name:
Last Name:VALADEZ-LOGAN
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 1:1906 W GARVEY AVE S STE 108
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2652
Mailing Address - Country:US
Mailing Address - Phone:310-493-3996
Mailing Address - Fax:
Practice Address - Street 1:1906 W GARVEY AVE S STE 108
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2652
Practice Address - Country:US
Practice Address - Phone:310-493-3996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89879104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker