Provider Demographics
NPI:1588211007
Name:VALENCIA, YARITZA
Entity Type:Individual
Prefix:
First Name:YARITZA
Middle Name:
Last Name:VALENCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 E HATCH RD
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95351-5001
Mailing Address - Country:US
Mailing Address - Phone:209-200-9893
Mailing Address - Fax:
Practice Address - Street 1:7567 AMADOR VALLEY BLVD STE 109
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2442
Practice Address - Country:US
Practice Address - Phone:866-206-2008
Practice Address - Fax:866-317-1665
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician