Provider Demographics
NPI:1689082505
Name:MENESES, VALINDA SUMMER
Entity Type:Individual
Prefix:
First Name:VALINDA
Middle Name:SUMMER
Last Name:MENESES
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 1:2610 INDUSTRY WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-4283
Mailing Address - Country:US
Mailing Address - Phone:310-631-8004
Mailing Address - Fax:310-631-5875
Practice Address - Street 1:2610 INDUSTRY WAY
Practice Address - Street 2:SUITE A
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-4283
Practice Address - Country:US
Practice Address - Phone:310-631-8004
Practice Address - Fax:310-631-5875
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health