Provider Demographics
NPI:1457932022
Name:VALDEZ-OLGUIN, DARLENE SUSAN (PHD, LMFT)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:SUSAN
Last Name:VALDEZ-OLGUIN
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 BREA BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-4128
Mailing Address - Country:US
Mailing Address - Phone:714-732-1773
Mailing Address - Fax:909-367-2922
Practice Address - Street 1:1370 BREA BLVD STE 210
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-4128
Practice Address - Country:US
Practice Address - Phone:714-732-1773
Practice Address - Fax:909-367-2922
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMR22525106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMR22525OtherBOARD OF BEHAVIORAL SCIENCE EXAMINERS