Provider Demographics
NPI:1780288589
Name:VALERO, KRISTINA (LMSW)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:VALERO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:GODINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83653-0009
Mailing Address - Country:US
Mailing Address - Phone:208-467-4431
Mailing Address - Fax:208-466-5359
Practice Address - Street 1:808 CLEVELAND BLVD
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-4149
Practice Address - Country:US
Practice Address - Phone:208-318-1333
Practice Address - Fax:208-466-5359
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-39657104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker