Provider Demographics
NPI:1467611145
Name:VALENTE, VINCENT GARRETT (MFT)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:GARRETT
Last Name:VALENTE
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 MILIA ST
Mailing Address - Street 2:
Mailing Address - City:KALAHEO
Mailing Address - State:HI
Mailing Address - Zip Code:96741-8743
Mailing Address - Country:US
Mailing Address - Phone:650-464-7418
Mailing Address - Fax:
Practice Address - Street 1:3424 POIPU RD
Practice Address - Street 2:
Practice Address - City:KOLOA
Practice Address - State:HI
Practice Address - Zip Code:96756-9522
Practice Address - Country:US
Practice Address - Phone:650-464-7418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 44596106H00000X
HIMFT-761-0106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist