Provider Demographics
NPI:1972633873
Name:FOSTER-YOUNG, VALERIE ANN (MFT)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:ANN
Last Name:FOSTER-YOUNG
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16738 LAKESHORE DR STE H-330
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-4930
Mailing Address - Country:US
Mailing Address - Phone:951-291-0255
Mailing Address - Fax:951-291-0455
Practice Address - Street 1:16738 LAKESHORE DR STE H-330
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-4930
Practice Address - Country:US
Practice Address - Phone:951-291-0255
Practice Address - Fax:951-291-0455
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 35620106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX202518OtherTEXAS STATE BOARD OF EXAMINERS OF MARRIAGE AND FAMILY THERAPIES