Provider Demographics
NPI:1639284987
Name:VALDEZ, TRUDI L (MSW)
Entity Type:Individual
Prefix:
First Name:TRUDI
Middle Name:L
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:TRUDI
Other - Middle Name:L
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:2203 UTAH ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4741
Mailing Address - Country:US
Mailing Address - Phone:505-256-2774
Mailing Address - Fax:505-256-5761
Practice Address - Street 1:1501 SAN PEDRO DR SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-5153
Practice Address - Country:US
Practice Address - Phone:505-256-2774
Practice Address - Fax:505-256-5761
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-05521104100000X
NMI-066111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker