Provider Demographics
NPI:1821772765
Name:VALLE CENTRAL FAMILY SERVICES
Entity Type:Organization
Organization Name:VALLE CENTRAL FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:831-243-8891
Mailing Address - Street 1:4420 N 1ST ST STE 117B
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-2328
Mailing Address - Country:US
Mailing Address - Phone:831-243-8891
Mailing Address - Fax:
Practice Address - Street 1:4420 N 1ST ST STE 117B
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-2328
Practice Address - Country:US
Practice Address - Phone:831-243-8891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1316205156Medicaid