Provider Demographics
NPI:1265246250
Name:QUESADA VALDES, MAIBELYS
Entity type:Individual
Prefix:
First Name:MAIBELYS
Middle Name:
Last Name:QUESADA VALDES
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 1:2100 ARNEY LN APT J105
Mailing Address - Street 2:
Mailing Address - City:WOODBURN
Mailing Address - State:OR
Mailing Address - Zip Code:97071-8473
Mailing Address - Country:US
Mailing Address - Phone:650-303-5351
Mailing Address - Fax:
Practice Address - Street 1:2100 ARNEY LN APT J105
Practice Address - Street 2:
Practice Address - City:WOODBURN
Practice Address - State:OR
Practice Address - Zip Code:97071-8473
Practice Address - Country:US
Practice Address - Phone:650-303-5351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10251704106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician