Provider Demographics
NPI:1629793476
Name:DEL VALLE, MANUEL JR
Entity Type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:
Last Name:DEL VALLE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2534 MCARTHUR AVE SPC 90
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-1708
Mailing Address - Country:US
Mailing Address - Phone:408-849-3531
Mailing Address - Fax:
Practice Address - Street 1:3000 SCOTT BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95054-3321
Practice Address - Country:US
Practice Address - Phone:408-849-3531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician