Provider Demographics
NPI:1902225253
Name:HOUGHTON, VALERIE RUNYAN (RN, MFT)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:RUNYAN
Last Name:HOUGHTON
Suffix:
Gender:F
Credentials:RN, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 S BASCOM AVE STE 138
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3512
Mailing Address - Country:US
Mailing Address - Phone:408-293-5853
Mailing Address - Fax:408-293-0458
Practice Address - Street 1:1190 S BASCOM AVE STE 138
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3512
Practice Address - Country:US
Practice Address - Phone:408-293-5853
Practice Address - Fax:408-293-0458
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC18373106H00000X
CA289176163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health