Provider Demographics
| NPI: | 1770063422 |
|---|---|
| Name: | VALERO, ROSE MARIE (PSYD) |
| Entity type: | Individual |
| Prefix: | DR |
| First Name: | ROSE |
| Middle Name: | MARIE |
| Last Name: | VALERO |
| Suffix: | |
| Gender: | |
| Credentials: | PSYD |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 1560 E CHEVY CHASE DR STE 130 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | GLENDALE |
| Mailing Address - State: | CA |
| Mailing Address - Zip Code: | 91206-4140 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 1560 E CHEVY CHASE DR STE 130 |
| Practice Address - Street 2: | |
| Practice Address - City: | GLENDALE |
| Practice Address - State: | CA |
| Practice Address - Zip Code: | 91206-4140 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 818-240-0340 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2018-08-21 |
| Last Update Date: | 2025-03-04 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| CA | PSY33509 | 102L00000X, 103T00000X, 103TA0400X, 103TA0700X, 103TB0200X, 103TC1900X, 103TC2200X, 103TF0000X, 103TH0004X, 103TM1800X, 103TP0814X, 103TP2701X, 103TR0400X |
| 390200000X | ||
| CA | 33509 | 103TC0700X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical |
| No | 102L00000X | Behavioral Health & Social Service Providers | Psychoanalyst | |
| No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | |
| No | 103TA0400X | Behavioral Health & Social Service Providers | Psychologist | Addiction (Substance Use Disorder) |
| No | 103TA0700X | Behavioral Health & Social Service Providers | Psychologist | Adult Development & Aging |
| No | 103TB0200X | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral |
| No | 103TC1900X | Behavioral Health & Social Service Providers | Psychologist | Counseling |
| No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent |
| No | 103TF0000X | Behavioral Health & Social Service Providers | Psychologist | Family |
| No | 103TH0004X | Behavioral Health & Social Service Providers | Psychologist | Health |
| No | 103TM1800X | Behavioral Health & Social Service Providers | Psychologist | Intellectual & Developmental Disabilities |
| No | 103TP0814X | Behavioral Health & Social Service Providers | Psychologist | Psychoanalysis |
| No | 103TP2701X | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy |
| No | 103TR0400X | Behavioral Health & Social Service Providers | Psychologist | Rehabilitation |
| No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
