Provider Demographics
NPI:1679294524
Name:VALENZUELA, DOMINIQUE JENNIFER (ASW)
Entity Type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:JENNIFER
Last Name:VALENZUELA
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 HOWE AVE STE 455
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-1086
Mailing Address - Country:US
Mailing Address - Phone:916-454-2345
Mailing Address - Fax:
Practice Address - Street 1:3234 MARYSVILLE BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-1411
Practice Address - Country:US
Practice Address - Phone:916-454-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health