Provider Demographics
NPI:1265715940
Name:VALENZUELA, ALEXANDER (MFT)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:VALENZUELA
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15010 FIR ST
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-4316
Mailing Address - Country:US
Mailing Address - Phone:760-669-5297
Mailing Address - Fax:760-669-5905
Practice Address - Street 1:15010 FIR ST
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-4316
Practice Address - Country:US
Practice Address - Phone:760-553-6314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50502106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty