Provider Demographics
NPI:1497479018
Name:CENTENO VALLES, PEDRO JOSE (PHD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:JOSE
Last Name:CENTENO VALLES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LINDEN OAKS STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2831
Mailing Address - Country:US
Mailing Address - Phone:585-586-1600
Mailing Address - Fax:
Practice Address - Street 1:100 LINDEN OAKS STE 200
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2831
Practice Address - Country:US
Practice Address - Phone:585-586-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist