Provider Demographics
NPI:1992184642
Name:VALENZUELA, DELIA VANESSA (LCSW)
Entity Type:Individual
Prefix:
First Name:DELIA
Middle Name:VANESSA
Last Name:VALENZUELA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45805 FARGO ST # 2336
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-4584
Mailing Address - Country:US
Mailing Address - Phone:760-771-7327
Mailing Address - Fax:
Practice Address - Street 1:3001 E TAHQUITZ CANYON WAY
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6982
Practice Address - Country:US
Practice Address - Phone:760-771-7327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA978331041C0700X
CAASW73380101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health