Provider Demographics
NPI:1184458002
Name:VALDEZ, IVONNE M (ACSW # 116203)
Entity type:Individual
Prefix:MS
First Name:IVONNE
Middle Name:M
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:ACSW # 116203
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 SIERRA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3113
Mailing Address - Country:US
Mailing Address - Phone:951-715-3126
Mailing Address - Fax:
Practice Address - Street 1:5425 SIERRA VISTA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3113
Practice Address - Country:US
Practice Address - Phone:951-715-3126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical