Provider Demographics
NPI:1023467883
Name:VALINE-FOLEY, MARILEE
Entity type:Individual
Prefix:
First Name:MARILEE
Middle Name:
Last Name:VALINE-FOLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 OCEAN BREEZE WAY
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-2022
Mailing Address - Country:US
Mailing Address - Phone:858-836-8449
Mailing Address - Fax:
Practice Address - Street 1:515 OCEAN BREEZE WAY
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-2022
Practice Address - Country:US
Practice Address - Phone:858-836-8449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-11
Last Update Date:2016-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT90482106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist