Provider Demographics
NPI:1932488038
Name:SEGURA, VALERIE DIANE (BCBA)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:DIANE
Last Name:SEGURA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1882 CHERRYWOOD PL
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-2614
Mailing Address - Country:US
Mailing Address - Phone:209-227-0212
Mailing Address - Fax:
Practice Address - Street 1:1882 CHERRYWOOD PL
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336
Practice Address - Country:US
Practice Address - Phone:209-227-0212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11417878103K00000X
CA11417878103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst