Provider Demographics
NPI:1134547391
Name:CRUZ, VALERIE (CADC II CA)
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:CADC II CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91768-3325
Mailing Address - Country:US
Mailing Address - Phone:909-865-2336
Mailing Address - Fax:
Practice Address - Street 1:17727 E CYPRESS ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-2634
Practice Address - Country:US
Practice Address - Phone:269-678-2677
Practice Address - Fax:626-858-4923
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA143743I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA143743IOtherSUBSTANCE ABUSE COUNSELOR